Korean J Ophthalmol.  2012 Apr;26(2):97-103. 10.3341/kjo.2012.26.2.97.

Anterior Chamber Configuration Changes after Cataract Surgery in Eyes with Glaucoma

• Kim M
• Park KH
• Kim TW
• Kim DM

• KMID: 1364862
• DOI: http://doi.org/10.3341/kjo.2012.26.2.97

Abstract

PURPOSE
To evaluate changes in anterior chamber depth (ACD) and angle width induced by phacoemulsification and intraocular lens (IOL) implantation in eyes with glaucoma, using anterior segment optical coherence tomography (AS-OCT).
METHODS
Eleven eyes of 11 patients with angle-closure glaucoma (ACG) and 12 eyes of 12 patients with open-angle glaucoma (OAG) underwent phacoemulsification and IOL implantation. Using AS-OCT, ACD and angle parameters were measured before and 2 days after surgery. Change in intraocular pressure (IOP) and number of ocular hypotensive drugs were evaluated.
RESULTS
After surgery, central ACD and angle parameters increased significantly in eyes with glaucoma (p < 0.05). Prior to surgery, mean central ACD in the ACG group was approximately 1.0 mm smaller than that in the OAG group (p < 0.001). Post surgery, mean ACD of the ACG group was still significantly smaller than that of the OAG group. No significant differences were found in angle parameters between the ACG and OAG groups. In the ACG group, postoperative IOP at the final visit was significantly lower than preoperative IOP (p = 0.018) and there was no significant change in the number of ocular hypotensive medications used, although clinically, patients required fewer medications. In the OAG group, the IOP and number of ocular hypotensive drugs were almost unchanged after surgery.
CONCLUSIONS
The ACD and angle width in eyes with glaucoma increased significantly after phacoemulsification and IOL implantation. Postoperative ACD significantly differed between the ACG and OAG groups, whereas angle parameters did not differ.

Keyword

Angle-closure glaucoma; Anterior chamber; Anterior eye segment; Cataract extraction; Open-angle glaucoma

MeSH Terms

Aged
Aged, 80 and over
Anterior Chamber/anatomy & histology/*surgery
Female
Glaucoma, Angle-Closure/drug therapy/pathology/*surgery
Glaucoma, Open-Angle/drug therapy/pathology/*surgery
Humans
Intraocular Pressure
Lens Implantation, Intraocular/*adverse effects
Male
Middle Aged
Phacoemulsification/*adverse effects
Postoperative Period
Preoperative Period
Tomography, Optical Coherence

Figure

• 

  Fig. 1 Anterior segment optical coherence tomography showed changes in the anterior chamber configuration induced by phacoemulsification and posterior chamber intraocular lens implantation in eyes with angle-closure glaucoma (ACG) and open-angle glaucoma (OAG). Preoperatively, the anterior chamber depth and angle width in eyes with ACG (left) were smaller than in the eyes with OAG (right). However, the anterior chamber depth and angle width were almost identical in eyes with ACG and OAG after cataract surgery.

• 

  Fig. 2 Change in mean intraocular pressure (IOP) and the number of ocular hypotensive medications needed in the two groups, preoperatively and postoperatively. (A) For the angle-closure glaucoma (ACG) group, the IOP showed a tendency to decrease during the immediate postoperative period and the final IOP was significantly decreased compared to the preoperative IOP (*p < 0.05). In contrast, the IOP for the open-angle glaucoma (OAG) group showed no significant difference after cataract surgery. (B) The number of hypotensive medications was also decreased after surgery in the ACG group whereas it was almost identical in the OAG group.

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