Abstract
Abstract: :
Purpose: To study changes in anterior chamber depth (ACD) with Ultrasound Biomicroscopy (UBM) before and after pediatric cataract surgery with the technique of posterior capsulorhexis with optic capture and compare to fellow eye in which IOL was positioned in the bag without capture. No previous study has evaluated anterior chamber depth using UBM in optic capture. By placing the IOL optic posterior to the posterior capsulorhexis opening an increase in anterior chamber depth may require an adjustment in IOL power calculation. Methods: Prospective evaluation of three patients with developmental cataracts undergoing cataract surgery, posterior capsulorhexis with optic capture. An Acrysoft acrylic posterior chamber IOL was implanted in each case. Examination under anesthesia (EUA) performed to obtain keratometry readings, axial length by A–Scan and UBM anterior chamber depth measurements. An average of three ACD measurements before and after cataract surgery, were used for statistical analysis. Pair t–test was used to compare ACD measurements. Results: Three patients (2 females and 1 male), ages ranging from 7 months to 43 months, mean age was 23.3 months (SD ±18.2). Case 1 had a change in RE ACD of 1.48 mm (p=0.0003) from preoperative to postoperative measurements. The postoperative ACD difference between RE and LE was 0.23 mm (p=0.1058). Both eyes underwent cataract surgery with posterior chamber IOL with optic capture. Case 2 had a change in ACD RE of 0.94 mm (p value=0.0019) from preoperative to postoperative measurements. The right eye was compared to the left eye, which had previously undergone cataract surgery with posterior chamber IOL implantation in the capsular bag without optic capture. The postoperative ACD difference between the RE and LE was 1.06 mm (p=0.0010). Case 3 had a change in ACD LE of 0.29 mm (p=0.0157) from baseline preoperative to postoperative measurements. Conclusions: A significant increase in anterior chamber depth after pediatric cataract surgery with posterior chamber IOL implantation with optic capture was observed. In the one case which had optic capture in one eye and in the bag placement in the other, a significantly deeper ACD was measured in the optic capture eye using UBM. Because a difference in IOL placement results in up to 3.75 diopters of IOL error, our findings of an over deepening in ACD after optic capture are clinically significant for final surgical outcome of pediatric cataract surgery.
Keywords: cataract • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)