Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open-Angle Glaucoma

Abstract

Objectives: The goal of this study was to compare measurements of values such as the anterior chamber angle (ACA), thickness of the iris, thickness of the cornea, and the angle-opening distance (AOD) of eyes with primary open-angle glaucoma before and after undergoing phacoemulsification with intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT).

Methods: The data of 49 eyes of 39 glaucoma patients who presented at the Cataract and Refractive Surgery Unit of the Ophthalmology Clinic of , University of Health Sciences, Istanbul Traning and Research Hospital between December 2014 and May 2016 were included in the study. All of the patients were examined with AS-OCT. All of the preoperative and postoperative data were evaluated statistically using a paired t-test and the Wilcoxon test. A statistical significance level of alpha was accepted as p<0.05.

Results: The AS-OCT measurements of 39 patients (22 women and 17 men) with primary open-angle glaucoma were included in the study. The median age of the total population was 67±8years. No statistically significant difference was found between preoperative and postoperative measurements of the corneal thickness (p=0.480). However, there was a statistically significant difference between measurements of the ACA, AOD (500μm and 750μm), thickness of the iris curvature, anterior chamber depth, and trabecular-iris space area before and after the operation (p<0.001). Intraocular pressure (IOP) levels decreased significantly in the first and third months after surgery (p=0.019; p=0.003, respectively).

Conclusion: This study with AS-OCT imaging has confirmed after phacoemulsification and intraocular lens implantation in patients with glaucoma, the angle of the anterior chamber grows wider. As a result, IOP decreases and becomes easier to control.

Keywords: Anterior chamber optical coherence tomography; anterior opening distance; cataract; phacoemulsification; primary open-angle glaucoma.

Figure 1

Images of optical coherence tomography measurements. (a) CCT: Central corneal thickness; (b) ACA: Anterior chamber angle; (c) Iris thickness; (d) AOD: Anterior opening distance; (e) MIBH: Maximum iris bow height; (f) ACD: Anterior chamber depth; (g) TISA: Trabecular iris space area. All of these images were digitally processed with Microsoft Paint (Microsoft Corp., Redmond, WA, USA).