Changes of Anterior Chamber Depth and Angle After Cataract Surgery Measured by Anterior Segment OCT

Dong Ho Chang; Seung Chan Lee; Kyung Hyun Jin

doi:10.3341/jkos.2008.49.9.1432

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Chang, Lee, and Jin: Changes of Anterior Chamber Depth and Angle After Cataract Surgery Measured by Anterior Segment OCT

Original Article

J Korean Ophthalmol Soc 2008;49(9):1443-1452.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.9.1432

Changes of Anterior Chamber Depth and Angle After Cataract Surgery Measured by Anterior Segment OCT

Dong Ho Chang, M.D.¹, Seung Chan Lee, M.D.², Kyung Hyun Jin, M.D.¹

¹Department of Ophthalmology, KyungHee University College of Medicine, Seoul, Korea

²Department of Ophthalmology, Kangwon University College of Medicine, Gangwon, Korea

Address reprint requests to Kyung Hyun Jin, M.D.Department of Ophthalmology, KyungHee University College of Medicine #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea Tel: 82-2-958-8451, Fax: 82-2-966-7340, E-mail: khjinmd@khmc.or.kr

Received 11 June 2008 Accepted 11 July 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the change of anterior chamber parameters according to cataract severity after cataract surgery and to determine its relationship to the severity of cataract by using anterior segment optical coherence tomography.

Methods

We measured the anterior chamber parameters in 19 eyes of 14 patients before, 1 week after, and 1 month after cataract surgery by slit lamp-adapted optical coherence tomography (SL-OCT). The measured parameters were as follows : the anterior chamber depth (ACD), the angle-opening distance 250 μ m from the scleral spur (AOD250), the angle-opening distance 500 μ m from the scleral spur (AOD500), and the trabecular-iris angle (TIA). We analyzed the relationship between the severity of cataract and the change of the anterior chamber parameters.

Results

The ACD, AOD250, AOD500, and TIA increased significantly at postoperative 1 week ( P=0.000, 0.002, 0.005, 0.022) and 1 month ( P=0.000, 0.004, 0.001, 0.002). The preoperative parameters were negatively correlated with the differences between the postoperative 1 week and preoperative parameters (γ = -0.834, -0.591, -0.421, -0.826) and between postoperative 1 month and preoperative parameters (γ = -0.659, -0.700, -0.770, -0.821). The change of parameters at postoperative 1 week (by N P=0.959, 0.916, 0.824, 1.000, by C P=0.454, 0.665, 0.578, 0.578) and 1 month (by N P=0.858, 0.973, 0.959, 0.959, by C P=0.999, 0.207, 0.950, 0.981) were not significantly different according to the severity of cataract (N, C).

Conclusions

Our results showed that cataract surgery significantly deepened the anterior chamber and widened its angle. The shallower and narrower the preoperative anterior chamber depth and angle were, respectively, the greater the postoperative changes of anterior chamber depth and angle were.

Keywords: Anterior chamber depth (ACD), Angle-opening distance 250 (AOD250), Angle-opening distance 500 (AOD500), Slit-lamp adapted optical coherence tomography (SL-OCT), Trabecular-iris angle (TIA)

References

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Figure 1.

The definition of anterior chamber parameters. The anterior chamber depth (ACD) can be measured between the endothelium and the lens surface. The angle-opening distance was measured on a line perpendicular to the trabecular meshwork at points 250 µm (AOD250) and 500 µm (AOD500) from the scleral spur. The trabecular-iris angle was measured with the apex in the iris recess and the arms of the angle passing through a point on the trabecular meshwork 500 µm from the scleral spur and the point on the iris perpendicularly opposite.

Figure 2.

The anterior segment OCT (optical coherence tomography) image by slit-lamp-adapted OCT and anterior chamber parameters of the anterior chamber in phakic eye (A) and pseudophakic eye (B). ACD1, which is measured between the inner corneal surface and the intraocular lens surface, extends into the posterior chamber (Pavlin’s original definition). ACD2, which is measured between the inner corneal surface and the plane of the posterior aspect of the iris at pupillary margin, represents the real anterior chamber depth in eyes with pseudophakia. As ACD1 extends into the posterior chamber, it is not the real ACD in pseudophakia. AOD250, which is the angle-opening distance at 250 µm from the scleral spur. AOD500, which is the angle-opening distance at 500 µm from the scleral spur. TIA, which is the trabecular-iris angle.

Figure 3.

Anteior segment optical coherence tomography (OCT) image before cataract surgery (A), postoperative 1 week (B), postoperative 1 month (C). Note deepening of the anterior chamber depth (ACD), flattening of the convex iris configuration, and widening of the angle after cataract surgery.

Figure 4.

The changes of anterior chamber parameters before and after surgery. (A) ACD change. (B) TIA change. (ACD, anterior chamber depth; TIA, trabecular-iris angle; P, p-value by Wilcoxon sign rank test)

Figure 5.

The changes of anterior chamber parameters before and after surgery. (A) AOD250 change. (B) AOD500 change. (AOD250, angle-opening distance at 250 µm from scleral spur; AOD500, angle-opening distance at 500 µm from scleral spur; P, p-value by Wilcoxon sign rank test)

Figure 6.

The preoperative anterior chamber parameters and ratio of postoperative 1 week parameters. X-axis: preoperative value, Y-axis: postoperative 1 week value/preoperative value (A) ACD (B) AOD250 (C) AOD500 (D) TIA. (ACD, anterior chamber depth; AOD250, angle-opening distance at 250 µm from scleral spur; AOD500, angle-opening distance at 500µm from scleral spur, TIA, trabecular-iris angle)

Table 1.

The anterior chamber parameters of before and after small-incisional cataract surgery 1week and 1month

Variable	Preoperative	1 week	1 month	1 week difference	1 month difference
ACD (µm)∗	2670.32±653.66	3591.21±456.91	3735.63±605.34	920.89±698.45	1065.32±779.79
AOD250 (µm)^†	342.58±127.27	470.11±123.78	470.16±113.10	127.53±149.33	127.58±154.30
AOD500 (µm)^‡	532.53±226.22	725.05±235.07	768.32±150.31	192.53±244.09	235.79±244.74
TIA (degrees)^$	34.92±13.36	43.26±8.66	48.37±7.92	8.34±13.19	13.45±13.01

^∗ ACD=anterior chamber depth; distance at 500 µm from the scleral spur;

^† AOD250=angle-opening distance at 250 µm from the scleral spur;

^℡ TIA=trabecular-iris angle.

^$ AOD500=angle-opening

Table 2.

The correlation efficients∗ of differences of anterior chamber parameters before and after small-incisional cataract surgery 1 week and 1 month

Variable	1 week’s difference	1 month’s difference	1 week’s ratio	1 month’s ratio
ACD (µm)^†	-0.834	-0.659	-0.875	-0.789
AOD250 (µm)^‡	-0.591	-0.700	-0.810	-0.792
AOD500 (µm)^§	-0.421	-0.770	-0.638	-0.817
TIA (degress)^∏	-0.826	-0.821	-0.855	-0.894

^∗ by Spearman's rho correlation

^† ACD=anterior chamber depth

^‡ AOD250=angle-opening distance at 250 µm from the scleral spur

^§ AOD500=angle-opening distance at 500 µm from the scleral spur

^∏ TIA=trabecular-iris angle.

Table 3.

The change of the anterior segment parameters and P value at postoperative 1 week according to the nuclear opacity by LOCS Ⅲ

Variable	Group 1 (N2, N3)	Group 2 (N4, N5)	P value∗
ACD (µm)^†	873.60±711.48	973.44±722.66	0.959
AOD250 (µm)^‡	131.76±126.13	122.89±179.53	0.916
AOD500 (µm)^§	157.00±273.45	232.00±215.87	0.824
TIA (degress)^∏	9.00±12.97	7.61±14.18	1.000

^∗ by Kolmogorov-Smirnov Z test; scleral spur

^† ACD=anterior chamber depth

^‡ AOD250=angle-opening distance at 250 µm from the scleral spur

^§ AOD500=angle-opening distance at 500 µm from the scleral spur

^∏ TIA=trabecular-iris angle

Table 4.

The change of the anterior segment parameters and P value at postoperative 1 month according to the nuclear opacity by LOCS Ⅲ

Variable	Group 1 (N2, N3)	Group 2 (N4, N5)	P value∗
ACD (µm)^††	1129.30±965.33	994.22±555.88	0.858
AOD250 (µm)^‡	121.60±120.22	134.22±192.92	0.973
AOD500 (µm)^§	230.10±195.42	242.11±302.86	0.959
TIA (degress)^∏	14.80±11.70	11.94±14.89	0.959

^∗ by Kolmogorov-Smirnov Z test; scleral spur

^† ACD=anterior chamber depth

^‡ AOD250=angle-opening distance at 250 µm from the scleral spur

^§ AOD500=angle-opening distance at 500 µm from the scleral spur

^∏ TIA=trabecular-iris angle

Table 5.

The change of the anterior segment parameters and P value at postoperative 1 week according to the cortical opacity by LOCS Ⅲ

Variable	Group 1 (C2, C3)	Group 2 (C4, C5)	P value∗
ACD (µm)^†	916.15±625.20	931.17±904.39	0.454
AOD250 (µm)^‡	123.54±176.17	136.17±75.21	0.665
AOD500 (µm)^§	179.46±286.75	220.83±125.44	0.578
TIA (degress)^∏	7.58±15.66	9.98±5.76	0.578

^∗ by Kolmogorov-Smirnov Z test

^† ACD=anterior chamber depth

^‡ AOD250=angle-opening distance at 250 µm from the scleral spur

^§ AOD500=angle-opening distance at 500 µm from the scleral spur

^∏ TIA=trabecular-iris angle.

Table 6.

The change of the anterior segment parameters and P value at postoperative 1 month according to the cortical opacity by LOCS Ⅲ

Variable	Group 1 (C2, C3)	Group 2 (C4, C5)	P value∗
ACD (µm)^∗	1062.15±859.99	1072.17±643.39	0.999
AOD250 (µm)^‡	89.38±132.69	210.33±177.34	0.207
AOD500 (µm)^§	213.69±234.53	283.67±282.15	0.950
TIA (degress)^∏	12.39±13.48	15.73±12.80	0.981

^∗ by Kolmogorov-Smirnov Z test; scleral spur

^† ACD=anterior chamber depth

^‡ AOD250=angle-opening distance at 250 µm from the sclear spur

^§ AOD500=angle-opening distance at 500 µm from the scleral spur

^∏ TIA=trabecular-iris angle.

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