Journal List > J Korean Ophthalmol Soc > v.51(3) > 1008754

Shin, Lee, Kim, and Tchah: Changes in Anterior Chamber Depth and Angle After Phacoemulsification measured by Anterior Segment Optical Coherence Tomography

Abstract

Purpose

To evaluate changes in anterior chamber depth (ACD) and angle after phacoemulsification and intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT).

Methods

Seventy-eight eyes of 69 patients had uneventful phacoemulsification and IOL implantation using a clear corneal incision. Anterior segment OCT images of nasal and temporal angle quadrants were obtained before and at one month after surgery. The angle-referenced (ACD1), pupil-referenced (ACD2), lens-referenced (ACD3) ACDs, crystalline lens rise (CLR), nasal and temporal iridocorneal angles, angle opening distance at 500 μ m (AOD500), and trabecular iris surface area at 750 μ m (TISA750) were measured. Preoperative and postoperative measurements were compared using paired sample t-tests.

Results

The mean ACD1 was 3.19±0.24 mm preoperatively and 3.22±0.21 mm at one month postoperatively (P=0.21); ACD2 was 2.99±0.40 mm preoperatively and 3.56±0.28 mm at one month postoperatively (P<0.05); ACD3 was 2.75±0.41 mm preoperatively and 4.00±0.27 mm at one month postoperatively (P<0.05). The mean iridocorneal angles, AOD500, and TISA750 for both nasal and temporal sides increased significantly at the postoperative examinations (P<0.05).

Conclusions

Changes in anterior chamber angle after cataract surgery can be objectively quantified by anterior segment OCT. Deepening of the anterior chamber and widening of the nasal and temporal angles after cataract extraction were shown on AS-OCT.

References

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Figure 1.
(A) Anterior segment OCT image of the left eye of an 55-year-old man before phacoemulsification and IOL implantation; ACD1 is 3.02 mm (2.47+0.55), ACD3 is 2.47 mm, and CLR is 0.55 mm. (B) Postoperative image of the same eye; ACD1 is 3.06 mm (3.86–0.80). and ACD3 is 3.86 mm (ACD1=angle-referenced anterior chamber depth; ACD3=lens-referenced anterior chamber depth; CLR=crystalline lens rise).
jkos-51-353f1.tif
Figure 2.
(A) Anterior segment OCT image of the right eye of an 51-year-old man before phacoemulsification and IOL implantation; ACD2 is 3.48 mm. (B) Postoperative image of the same eye; ACD2 is 3.81 mm (ACD2=pupil-referenced anterior chamber depth).
jkos-51-353f2.tif
Figure 3.
(A) Anterior segment OCT image of the left eye of an 70-year-old man before phacoemulsification and IOL implantation; the nasal iridocorneal angle is 29.5 degrees and the temporal iridocorneal angle is 26.0 degrees, the nasal AOD500 is 0.390 mm and the temporal AOD500 is 0.435 mm, the nasal TISA750 is 0.274 mm2 and the temporal TISA750 is 0.306 mm2. (B) Postoperative image of the same eye; the nasal iridocorneal angle is 34.2 degrees, and the temporal iridocorneal angle is 36.5 degrees, the nasal AOD500 is 0.698 mm and the temporal AOD500 is 0.460 mm, the nasal TISA750 is 0.458 mm2 and the temporal TISA750 is 0.319 mm2. (AOD500=angle opening distance at 500 um; TISA750=trabecular-iris space at 750 μm).
jkos-51-353f3.tif
Figure 4.
Correlation between CLR and preoperative ACD.
* Pearson correlation test (CLR=crystalline lens rise; ACD=anterior chamber depth; ACD1=angle-referenced anterior chamber depth; ACD2= pupil-referenced anterior chamber depth; ACD3=lens-referenced anterior chamber depth).
jkos-51-353f4.tif
Table 1.
Changes in anterior chamber parameters before and after cataract surgery
Parameter Mean± SD
Increase P-value*
preoperative postoperative
ACD1 (mm) 3.19±0.24 3.22±0.21 0.90% P=0.215
ACD2§ (mm) 2.99±0.40 3.56±0.28 20.70% P<0.001
ACD3 (mm) 2.75±0.41 4.00±0.27 45.50% P<0.001
Nasal angle (degrees) 19.87±12.53 32.79±10.52 65% P<0.001
Temporal angle (degrees) 21.54±12.10 33.02±8.89 53.30% P<0.001
AOD500 nasal (mm) 0.322±0.199 0.546±0.202 69.60% P<0.001
AOD500 temporal (mm2) 0.366±0.239 0.559±0.234 52.70% P<0.001
TISA750** nasal (mm2) 0.218±0.127 0.362±0.127 66.10% P<0.001
TISA750** temporal (mm2) 0.248±0.145 0.371±0.149 49.60% P<0.001

* Paired samples T-tests

SD=standard deviation

ACD1=angle-referenced anterior chamber depth

§ ACD2=pupil-referenced anterior chamber depth

ACD3=lens-referenced anterior chamber depth

AOD500=angle opening distance at 500 μm

** TISA750= trabecular-iris space at 750 μm.

Table 2.
Correlation between CLR and preoperative anterior chamber depth
Parameter CLR P-value*
ACD1§ r=-0.26 0.818
ACD2 r=-0.816 <0.001
ACD3 r=-0.864 <0.001
* Pearson correlation test; r=Pearson correlation coefficient;

CLR=crystalline lens rise

§ ACD1=angle-referenced anterior chamber depth

ACD2=pupil-referenced anterior chamber ddepth

ACD3=lens-referenced anterior chamber depth.

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