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

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

• Chang DH
• Lee SC
• Jin KH

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 micrometer from the scleral spur (AOD250), the angle-opening distance 500 micrometer 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 (gamma=-0.834, -0.591, -0.421, -0.826) and between postoperative 1 month and preoperative parameters (gamma=-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.

Keyword

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)

MeSH Terms

Anterior Chamber
Cataract
Eye
Humans
Tomography, Optical Coherence

Figure

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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.

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  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.

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  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.

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  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)

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  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)

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  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)

Reference

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