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L. A. Anderson, A. Gupta, N. Srikantha, S. Goverdhan, J. Kirwan; Shallow Anterior Chamber Depth Is Associated With Increased Surgical Complications During Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5578.
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To assess if smaller anterior chamber depth (ACD) is a risk factor for intra-operative complications during cataract surgery.
Data from an electronic cataract database was analysed for 8891 eyes at the Queen Alexandra Hospital, Portsmouth, UK. All eyes which had a central ACD measured were included in the study. All intra-operative complications and issues (posterior capsule rupture/dialysis, capsulorexis tears, iris prolapse, corneal oedema and descemet tears) were recorded. Complication rates were compared between ≤ 2.5mm and > 2.5mm ACD groups. Chi square (2- tailed with Yates correction) were used to calculate P values and odds ratios (OR) with 95% confidence intervals.
1138 eyes were identified as having an ACD ≤ 2.5 mm and 7753 had an ACD >2.5 mm. The overall complication rate was 3.56%. Complications were seen significantly more in the ACD ≤2.5 mm group as compared to the ACD >2.5 mm group, 54(4.75%) versus 263(3.40%) with an odds ratio of 1.42 (P=0.026, 95% CI = 1.05 -1.92). Posterior capsule rupture/zonular dialysis (+/- vitreous loss) was seen in 23 (2.0%) of the eyes with an ACD ≤ 2.5 mm compared to 95 (1.2%) in the > 2.5 mm ACD group (OR= 2.060, P=0.036, 95% CI = 1.64 -2.60) with an over 2 fold risk. A shallow anterior chamber with vitreous bulge was also significantly more common in the ≤ 2.5mm ACD group i.e., 51 (4.48%) versus 93 (1.2%) in the >2.5 mm group (OR= 3.386, P<0.0001, 95%CI = 2.70-5.50).
Patients with anterior chamber depths ≤ 2.5mm are significantly more at risk of developing complications during cataract surgery. ACD should be considered as a factor in risk stratification preoperatively.
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