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Anatomo-topographic changes and hydrodynamics of the eye after phacoemulsification

Session Details

Session Title: Surgical Outcomes

Session Date/Time: Monday 07/10/2013 | 08:00-09:30

Paper Time: 09:09

Venue: Auditorium (First Floor)

First Author: : M.Yugay RUSSIA

Co Author(s): :    A. Ryabtzeva   N. Nikitina           

Abstract Details

Purpose:

There is evidence of reduction of intraocular pressure (IOP) after phacoemulsification. The aim of the study was to identify reliable morphological changes of the anterior eye segment using ultrasound biomicroscopy (UBM) and identify changes in eye hydrodynamics after phacoemulsification.

Setting:

Moscow Regional Research Clinical Institute, Moscow, Russia

Methods:

60 patients (60 eyes) with cataract at the age of 51 to 77 years (mean age 68 years) underwent ultrasound cataract phacoemulsification with implantation of foldable intraocular lens. UBM was performed 1 day before and 1 day after phacoemulsification with a probe frequency of 50 MHz, the scanning area of 16 mm, the focus of 9 to 11 mm, the maximum resolution of 35 microns, the lateral resolution - 60 microns. The following parameters were measured: depth of the anterior chamber, distance "trabecula - iris" 500 microns from the scleral spur, distance "trabecula - ciliary processes", thickness of iris root, iris profile, maximum thickness of the ciliary body, and its thickness of 1 and 2 mm from the scleral spur, the anterior chamber angle, the angle between the iris and the sclera, the angle between the sclera and ciliary processes. Evaluation of intraocular pressure (IOP) with ocular response analyzer (ORA) was conducted 1 day before, 1 day after and 1 month after surgery. Electronic tonography was performed 1 day before and 1 month after surgery.

Results:

Statistically significant changes were registered in the anterior chamber depth (increase 51%), trabecular-iris distance (increase 22%), anterior chamber angle (increase 45%), sclera-iris angle (increase 26%) and angle sclera-ciliary processes (increase 15%). Goldmann correlated IOP remained almost unchanged (15,0 mm Hg and 15,5 mm Hg). Corneal-compensated IOP increased from 16,4 mm Hg to 18,4 mm Hg, and corneal hysteresis decreased from 9,8 mm Hg to 8,0 mm Hg. According to electronic tonography IOP decreased a month after surgery from 16,6 mm Hg to 13,2 mm Hg, ease outflow ratio increased from 0,15 mm ³ / min mm Hg to 0,23 mm ³ / min mm Hg, and secretion of aqueous humor remained virtually unchanged (0,91 mm³/ min).

Conclusions:

Decrease in IOP in 1 month after surgery is caused by facilitated outflow of aqueous fluid. It is based on morphological changes (increased anterior chamber depth, distance trabecula-iris, anterior chamber angle). Aqueous production remains unchanged. The temporary increase in corneal compensated IOP the first day after phacoemulsification can be associated with reactive syndrome.

Financial Interest:

NONE