Changes in Anterior Chamber Parameters After Uneventful Phacoemulsification in Normotensive Eyes wit

1
Changes in Anterior Chamber Parameters After
Uneventful Phacoemulsification in Normotensive
Eyes with Open Iridocorneal Angles Measured by
the Pentacam CES

• Özlenen Ömür Uçakhan,1 MD
• Muhip Özkan,2 PhD
• Ayfer Kanpolat,1 MD
• 1 Department of Ophthalmology, Ankara University
  School of Medicine, Ankara, Turkey
• 2 Department of Biometry and Genetic Animal
  Husbandry, Ankara University, Ankara, Turkey

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Purpose

• To quantify any change in the anterior chamber
  angle (ACA), depth (ACD) or volume (ACV)
  measurements obtained by the Pentacam rotating
  Scheimpflug camera (Oculus GmbH, Germany) after
  uneventful phacoemulsification surgery in
  normotensive eyes with open iridocorneal angles.

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Materials

• Prospective study
• Forty four eyes of 44 consecutive patients
  applying to undergo cataract extraction enrolled
• Exclusion Criteria
• Patients with glaucoma, pseudoexfoliation
  syndrome, history of angle closure, any previous
  ocular surgery, or any previous or concurrent
  ocular disease
• When both eyes of one patient underwent surgery,
  the first operated eye was included into the
  study.
• Surgery
• Phacoemulsification with temporal clear corneal
  incision IOL placement
• Measurements performed before and 3 months after
  surgery
• Uncorrected visual acuity
• Best spectacle-corrected visual acuity
• Slit lamp examination
• Pentacam CES
• Intraocular pressure (IOP) measurement (Goldmann
  applanation tonometry)
• Fundoscopy (in that order)

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Materials

• Pentacam CES system (Oculus GmbH, Germany)
• Rotating Scheimpflug camera and a monochromatic
  slit light source that rotate 360? together
  around the optical axis of the eye
• The system acquires 25 or 50 images of the
  anterior segment of the eye in 2 seconds
• The software enables evaluation and
  quantification of the anterior and posterior
  corneal elevation data, corneal thickness,
  anterior chamber volume (ACV), anterior chamber
  depth (ACD), anterior chamber angle (ACA) and
  lens volume and opacity from the acquired images.
  
• In this study
• The system was set to acquire 25 images per scan
  at the automatic release mode (images captured
  automatically)
• The software V 1.14 was used
• Three measurements were obtained from each
  patient eye and the best was used in quantitative
  analysis.

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Results

• The mean preoperative and postoperative anterior
  chamber parameters
• Pre- Post- Postoperative Postoperative-
• operative operative Preoperative Preoperative
  
• Ratio Difference
• ACV (mm3) 164.749.8 200.933.3 1.3000.341 36.2
  00
• ACD (mm) 3.00.8 3.90.9 1.3400.363 0.870
• ACA (degrees) 35.710.2 41.56.5
  1.2300.350 5.760
• Temporal (degrees) 33.08.3 39.97.1
  1.2600.303 6.910
• Nasal (degrees) 35.38.7 42.47.9
  1.2300.209 7.140
• Superior (degrees) 32.38.7 37.57.6
  1.1900.196 5.180
• Inferior (degrees) 36.39.5 43.86.1
  1.2700.310 7.480
• ACV Anterior chamber volume Statistically
  significant (lt0.005)
• ACD Anterior chamber depth
• ACA Anterior chamber angle

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Results
7
Results
8
Results
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Results

• An obvious backward shift of the iris could be
  noted at the Scheimpflug images, especially in
  eyes with veryshallow anterior chambers.

Postoperative month-3
Preoperative
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Results

• IOP
• The mean preoperative IOP 15.83.7 mmHg
• The mean postoperative IOP 13.23.9 mmHg (at
  postoperative month 3)
• The difference was statistically significant
  (plt0.0001)

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Conclusion

• In normotensive eyes with open iridocorneal
  angles, the anterior chamber volume and depth
  increases and the anterior chamber angle widens
  in all quadrants following uneventful
  phacoemulsification and IOL implantation.
• These changes are accompanied by a significant
  fall in the IOP 3 months postoperatively.
• The Pentacam CES allowed very easy, fast and
  noncontact quantification of the anterior chamber
  parameters pre- and postoperatively in all
  patient eyes.