Effects of Laser Peripheral Iridotomy on Corneal Endothelial Cell Density and Cell Morphology in Primary Angle Closure Suspect Subjects

355 Dear Editor, I read with interest the recent original article entitled “Effects of laser peripheral iridotomy on corneal endothelial cell density and cell morphology in primary angle closure suspect subjects” by Jamali et al in the Journal of Ophthalmic and Vision Research.[1] I would like to stress two major facts which are evidenced by findings reported in various publications, as the authors did not discuss these important issues. Firstly, there is an indisputable influence of racial background on ocular structures, either in the anterior or posterior segment of the eye, including retinal nerve fiber layer thickness (RNFL), endothelial cell density (ECD), and central corneal thickness (CCT) and intraocular pressure (IOP).[2,3] There have been several studies published in your valuable journal, J Ophthalmic Vis Res, that have discussed the importance of race on the biometric data of ocular structures as it pertains to Iranian subjects.[4] Despite this fact, the authors did not discuss this significant issue, which requires specific emphasis indeed. Secondly, we refer to the methods of this research. One eye was selected randomly to receive a peripheral iridectomy (PI) following gonioscopic confirmation of iridotrabecular contact of at least 180 degrees.[1] There are several examples in the literature where the comparison of two eyes is one of the best methods to evaluate the effects of clinical intervention with the fewest confounding factors.[5] Although it was possible to contrast endothelial cell characteristics between two eyes (the post‐PI with the virgin eye), the comparison is not mentioned in the published study. In fact, this comparison could provide excellent data regarding both short‐ and long‐term results of PI on corneal endothelial cell characteristics. Effects of Laser Peripheral Iridotomy on Corneal Endothelial Cell Density and Cell Morphology in Primary Angle Closure Suspect Subjects