1. Feb 24, 2019

A New Way to Screen PACS Patients

Researchers say that the presence or absence of the so-called triple hump can predict laser peripheral iridotomy efficacy, and may be useful for planning treatment

A new screening sign—the triple hump (TH)—worked well to predict the impact of laser peripheral iridotomy (LPI) on eyes with primary angle-closure suspect (PACS) patients, according to a cross-sectional study involving 84 individuals. Researchers noted that TH may be useful in planning treatment for such patients.

All participants were PACS patients. Investigators imaged patients prior to LPI, looking for a TH sign, described as “the characteristic configuration formed by the angulations between the crystalline lens's central anterior surface and both sides of the iris pigment epithelium.” They then compared intraocular pressure (IOP) in those with and without the TH sign. Among the results:

  • Preoperative IOP readings were similar in the two groups.
  • Postoperative IOP decreased by nearly 6.5% in those with the TH, a significant difference, to 12.88 mmHg from 14.07 mmHg preop.
  • Pressure remained essentially the same in TH-negative individuals pre- and postoperatively.



 Na K, Har A, Baek S, et al. Predicting the therapeutic efficacy of laser peripheral iridotomy for individuals with asymptomatic narrow angle: The triple hump sign. J Glaucoma. 2019 Feb;28(2):125-130. doi: 10.1097/IJG.0000000000001157