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Guofu Huang, Eduardo Gonzalez, Roland Lee, Thidarat Leeungurasatien, Pai-Huei Peng, Shan Lin; Anterior Chamber Depth, Iridocorneal Angle Width And Intraocular Pressure Changes After Uneventful Phacoemulsification: Narrow Versus Open Iridocorneal Angles. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6283.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the changes in the anterior chamber angle and the anterior chamber depth using AS-OCT and its correlation with intraocular pressure after phacoemulsification with intraocular lens implantation in narrow and open angle eyes.
In this prospective study, all subjects underwent phacoemulsification with foldable lens implantation for narrow(NA) and open angle eyes. Images of the anterior segment were obtained using a commercially available AS-OCT device under dark conditions. Goldmann applantation tonometry and 4-mirror gonioscopy using the Shaffer grading system were performed preoperatively. Anterior chamber angle grading ≤II in three or all quadrants was considered as narrow angle. Anterior chamber depth (ACD) and angle opening distance at 500µm (AOD500) anterior to the scleral spur were used to evaluate anterior chamber configuration before and after surgery. Correlation was evaluated between angle width and percent IOP reduction using Pearson two-tailed t test.
Data were collected from 63 eyes that underwent cataract surgery. Twenty six eyes were determined to be narrow angle from gonioscopy. Before surgery the mean AOD500 and ACD in the NA group were 181.19±69.63µm and 2.23±0.29 mm, respectively. At 6 months after surgery, the mean AOD500 and ACD in the NA group were 375.61±113.62µm and 3.74±0.21 mm, respectively. Anterior chamber angle widening postoperatively was approximately 70% in the NA group and 46% in control group. The postoperative IOP was reduced significantly in both groups. The amount of IOP reduction was 2.81±1.72 mmHg (18.21%) in the NA group and 1.55±2.22 mmHg (9.60%) in the control group, which were significantly different between the groups (p=0.025). ACD deepening and angle widening postoperatively had significant negative correlation with preoperative depth and width in the NA group (r=-0.699,p=0.000;r=-0.419,p=0.033, respectively). We also found weak but significant correlations between IOP decrease and angle widening (r=0.397,p=0.045) in the NA group.
Postoperative reduction in IOP was proportional to the increase in angle width in narrow angle eyes. Phacoemulsification with intraocular implantation may eliminate pupillary block and widen the angle to lessen angle crowding in cataract eyes with narrow angle configuration.
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