Changes in Anterior Chamber Depth and Angle After Phacoemulsification measured by Anterior Segment Optical Coherence Tomography

Chul Jin Shin; Joo Eun Lee; Jae Yong Kim; Hung Won Tchah

doi:10.3341/jkos.2010.51.3.353

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

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

Original Article

J Korean Ophthalmol Soc 2010;51(3):353-358.

Published online: 25 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.3.353

Changes in Anterior Chamber Depth and Angle After Phacoemulsification measured by Anterior Segment Optical Coherence Tomography

Chul Jin Shin, MD, Joo Eun Lee, MD, Jae Yong Kim, MD, PhD, Hung Won Tchah, MD, PhD

Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

Address reprint requests to Hung Won Tchah, MD, PhD Department of Ophthalmology, University of Ulsan, College of Medicine, Asan Medical Center #388-1 Pungnap-2-dong, Songpa-gu, Seoul 138-736, Korea Tel: 82-2-3010-3680, Fax: 82-2-470-6440, E-mail: HungTchah@amc.seoul.kr

Received 25 June 2009 Accepted 29 October 2009

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 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.

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Keywords: Angle, Anterior chamber depth, Anterior segment optical coherence tomography, Phacoemulsification

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).

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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).

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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).

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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).

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Table 1.

Changes in anterior chamber parameters before and after cataract surgery

Parameter	Mean± SD†		Increase	P-value*
Parameter	preoperative	postoperative	Increase	P-value*
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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