First Author: M.Pravosudova RUSSIA
Co Author(s): L. Balashevich
Purpose:
To analyse the eye anterior segment changes by using optical coherence tomography (OCT) after lensectomy.
Setting:
S.N. Fyodorov " Eye Microsurgery" clinic, St.-Petersburg Branch, Russia.
Methods:
We have examined the anterior segment parameters of 137 eyes (101 patients) before and after phacoemulsification with foldable IOL implantation. 47 eyes were the eyes with primary angle-closure glaucoma (PACG), 45 eyes - with primary open angle glaucoma (POAG), 45 eyes - without glaucoma. The eye anterior segment has been examined with high-speed AS-OCT (Visante, Carl Zeiss Meditec). The following variables were measured: the anterior chamber depth (the distance from the endothelium at the center of the cornea to the anterior pole of lens ACD1 before and to the center of pupillary plane ACD2 after lensectomy), the nasal iridocorneal angle (ICA), the angle-opening distance at 250 µm (AOD250) and 500 µm (AOD500) from the scleral spur.
Results:
We have revealed the increasing of the anterior chamber depth in all cases. It was more significant in eyes with PACG. Before surgery the mean ACD1 was 1.9 mm, postoperatively ACD2 was 3.18 mm. After lensectomy ACD has been increased to 1.66 times in eyes with PACG. In the other groups it has been increased to 1.45 times and to 1,44 times, relatively. Before surgery the mean nasal iridocorneal angle was 11.1 degrees in eyes with PACG, 19.6 degrees - with POAG, 21.2 degrees - without glaucoma, after surgery ICA has been increased to 2.8, 1.49, 1.35 times, relatively. The preoperative ICA difference between the group of eyes with PACG and the other ones has lost its significance after lensectomy. We have noticed the most increasing of AOD250 and AOD500 in eyes with PACG after surgery. In eyes with PACG the mean AOD250 and AOD500 increased from 100 µm to 170 µm (to 1.7 times) and 150 µm to 290 µm (to 1.9 times), relatively. In eyes with POAG AOD250 and AOD500 increased to 1.2 times, in eyes without glaucoma to 1.1 times.
Conclusions:
The data of our study revealed the deepening of the anterior chamber and the widening of its angle in all cases after lensectomy. After lensectomy there exist changes in the eye anterior segment structures and their correlations. They were the most significant in eyes with PACG. These changes create the favorable conditions for aqueous humor outflow. Our study suggests that lensectomy is effective procedure for intraocular pressure control in PACG eyes. FINANCIAL DISCLOSURE?: No
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