Glaucoma: investigating management of primary angle closure and treatment (IMPACT) study

This NIHR Portfolio Randomised Controlled Trial randomised one eye of patients with primary angle closure or primary angle closure suspects to laser iridotomy (LPI). The fellow eye remained untreated.

Patients were followed up and if the angle remained gonioscopically closed after laser, there was a further randomisation of these eyes to argon laser iridoplasty (ALPI) or monitoring.

The study has resulted in several publications centring around diurnal pressure in eyes with angle closure, the association of diurnal pressure with degree of angle opening in these patients, and the anatomical effect of ALPI in eyes that have received an iridotomy.

Collaborators include former PhD student Laura Sanchez Parra and Dr Ivailo Zhekov (Cambridge University Hospitals NHS Foundation Trust), who has continued the work to investigate dynamic features of the iris in these patients using SWEPT-source OCT techniques.

An additional NIHR portfolio study investigating ocular surface disease among patients with glaucoma has also involved a subsample of patients tested within VERI’s climate chamber to assess the behaviour of the ocular surface when environmentally stressed.

Professor Rupert Bourne
Professor Shahina Pardhan
Dr Ivailo Zhekov

Recent publications

Zhekov, I., Pardhan, S., Bourne, R. R. A., 2018. Ocular coherence tomography-measured changes over time in anterior chamber angle and diurnal intraocular pressure after laser iridotomy: IMPACT study. Clinical and Experimental Ophthalmology, 46(8), pp. 895-902. doi: 10.1111/ceo.13303

Bourne, R. R. A., Zhekov, I., Pardhan, S., 2017. Temporal ocular coherence tomography-measured changes in anterior chamber angle and diurnal intraocular pressure after laser iridoplasty: IMPACT study. British Journal of Ophthalmology, 101(7), pp. 886-891. doi: 10.1136/bjophthalmol-2016-308720

Sanchez-Parra, L., Pardhan, S., Buckley, R. J., Parker, M., Bourne, R. R. A., 2015. Diurnal Intraocular Pressure and the Relationship With Swept-Source OCT-Derived Anterior Chamber Dimensions in Angle Closure: The IMPACT Study. Investigative Ophthalmology & Visual Science, 56(5), pp. 2943-2949. doi: 10.1167/iovs.14-15385