Abstract: Objective To evaluate the changes in anterior segment configuration after surgical peripheral iridectomy (SPI) or primary trabeculectomy (PT) in chronic primary angle closure glaucoma (CPACG). Design Prospective comparative cases series. Participants Fifty-three eyes of 45 patients with CPACG from Zhongshan Ophthalmic Center, Sun Yat-Sen University were successively collected. Methods PI was performed in patients with the clock hours of peripheral anterior synechiae (PAS) ≤6, while PT was performed to patients with the clock hours of PAS>6. Anterior segment optical coherence tomography (AS-OCT) examination was performed before and 3 month after PI/PT. Main Outcome Measures Central anterior chamber depth (ACD), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), anterior chamber width (ACW), anterior chamber area(ACA), anterior chamber volume (ACV) and crystalline lens rise (CLR). Results After surgery, ARA (0.078±0.036 vs. 0.065±0.024 mm2 ), ACA (15.409±2.892 vs. 13.945±2.633 mm2 ) and ACV (91.021±22.387 vs. 83.445±21.791 mm3 ) increased significantly (t=-8.015～-2.727, P<0.001～0.042), while no changes were found in ACD, TISA, AOD, ACW and CLR (t=-1.374～0.561, P=0.102～0.774) in SPI group. However in PT group, all AS-OCT parameters shown no changes(t=-1.700～-0.002, P=0.388～0.998) after operation. Conclusions After SPI, AS-OCT parameters such as ARA, ACA and ACV increase, while PT can not change the anterior segment configuration in CPACG eyes. (Ophthalmol CHN, 2013, 22: 25-29)

Key words: chronic angle-closure glaucoma, angle structure, iridectomy, trabeculectomy, anterior segment optical coherence tomography