Femtosecond laser–assisted cataract surgery in eyes with shallow anterior chamber depth

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rita Mencucci ◽  
Chiara De Vitto ◽  
Michela Cennamo ◽  
Roberto Vignapiano ◽  
Matilde Buzzi ◽  
...  
2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Zhou Zhou ◽  
Li Li ◽  
Siming Zeng ◽  
Wenjing He ◽  
Min Li

Purpose. To compare femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification in shallow anterior chamber cataract patients with glaucoma or zonulysis. Methods. This was a single-center retrospective review of cataract surgeries in shallow anterior chamber and glaucoma patients between January 2016 and December 2018 in which a LenSx femtosecond laser was used. The outcome measures included pre- and postoperative uncorrected and corrected distance visual acuity (UDVA and CDVA), intraocular pressure (IOP), endothelial cell density (ECD), endothelial cell loss (ECL), and object scatter index (OSI). Results. One hundred and six eyes of 106 patients with a mean anterior chamber depth of 1.54 ± 0.51 mm were included in this study. Among them, 26 (23.2%) had zonulysis and 18 eyes had capsular tension ring implantation in general. The percentage of capsular tension ring implantation was statistically significantly lower in the FLACS group ( P  = 0.027). The UDVA, CDVA, ECD, and IOP were not statistically significant between the two groups at all time points. The postoperative ECL and OSI of the FLACS group was better than those of the conventional group ( P  < 0.01). Conclusions. FLACS can reduce ECL and improve visual quality compared to the conventional phacoemulsification in shallow anterior chamber patients. Also, it has the trend of reducing the use of capsular tension rings in subluxated cataracts. It is an ideal choice for patients with complicated cataract such as with shallow anterior chambers, glaucoma, and zonulysis.


2019 ◽  
Author(s):  
Man Hu ◽  
Qian Zheng ◽  
Zhangliang Li ◽  
Pingjun Chang ◽  
Yun-e Zhao

Abstract Background To assess the changes of anterior chamber angle in patients with shallow anterior chamber and normal anterior chamber after phacoemulsification and intraocular lens implantation (IOL) using anterior segment swept-source optical coherence tomography (AS-SS-OCT). Methods This was a prospective case control study; 60 eyes of 60 patients who underwent cataract surgery. Based on anterior chamber depth (ACD) and gonioscopy findings, the eyes were classified into two groups, shallow anterior chamber group (30 eyes) and normal anterior chamber group (30 eyes). AS-SS-OCT was used to measure ACD and angle parameters angle opening distance (AOD), angle recess area (ARA), trabecular iris space area(TISA), and trabecular iris angle (TIA). Serial changes in each group were measured before and 3 months after phacoemulsification and IOL, and the differences between the two groups were compared. Results All angle parameters including ACD, AOD, ARA, TISA, and TIA in both groups at 3 months after cataract surgery were significantly different from the preoperative values (p<0.01). In addition, we found significant differences of all angle parameters between groups of shallow anterior chamber (SAC) and normal anterior chamber (NAC) (All P< 0.05). Besides, the TISA750 in superior quadrant and anterior chamber volume (ACV) were significantly smaller in the group of SAC than those in the group of NAC (P = 0.041 and 0.002, respectively). Conclusions The parameters of anterior chamber increased significantly in both two groups but not increase to the same extent 3 months after phacoemulsification. Iris thickening may also be one of the narrow angle factors,not just age-related lens thickening.


2021 ◽  
Vol 14 (10) ◽  
pp. 1527-1532
Author(s):  
Qian Zheng ◽  
◽  
Zhang-Liang Li ◽  
Ping-Jun Chang ◽  
Yun-E Zhao ◽  
...  

AIM: To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens (IOL) implantation, based on anterior segment swept-source optical coherence tomography (AS-SS-OCT) measurements. METHODS: This was a prospective case control study; sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure (IOP). Based on anterior chamber depth (ACD) and gonioscopy findings, the eyes were divided into two groups: group of shallow anterior chamber and narrow angle (SAC group, 30 eyes); and group of normal anterior chamber group with wide angle (NAC group, 30 eyes). Measurements of ACD, anterior chamber volume (ACV), iris volume (IV), lens vault (LV), angle opening distance (AOD), angle recess area (ARA), trabecular iris space area (TISA), and trabecular iris angle (TIA) were conducted in each group before and 3mo after surgery. RESULTS: There was no significant difference in age, axial length (AL), corneal curvature, corneal diameter, intraocular pressure, and IV between two groups before surgery, except for the LV (P=0.000). ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation (3.69±0.38 vs 3.85±0.39 mm, P=0.025; 161.37±19.47 vs 178.26±20.30 mm3, P=0.002). AOD750, ARA750 in nasal and inferior quadrants, TISA750 in all quadrants except temporal, and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation (all P<0.05). CONCLUSION: Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects, but the angle related parameters including AOD750, ARA750, TISA750, TIA, TISA750, and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.


Author(s):  
Andrés Fernández-Vega Cueto ◽  
Ignacio Rodríguez-Una ◽  
Pedro P. Rodríguez-Calvo ◽  
José F. Alfonso

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 437
Author(s):  
Hana Abouzeid ◽  
Walter Ferrini ◽  
Murielle Bochud

Background and Objectives: To quantify the change in intraocular pressure (IOP) after phacoemulsification in patients having undergone femtolaser assisted cataract surgery (FLACS), and study the influence of the use of ultrasound on this change. Setting: Jules-Gonin Eye Hospital, University Department of Ophthalmology, Lausanne, Switzerland. Materials and Methods: Interventional study. Methods: All consecutive cases operated with FLACS and with complete data for the studied parameters were selected for inclusion in the study. Data had been prospectively collected and was analysed retrospectively. Linear regression was performed to explore the association of change in IOP with time of measure, ultrasound use, sex, age, and duration of surgery. Results: There was a mean decrease in intraocular pressure of 2.5 mmHg (CI 95% −3.6; −1.4, p < 0.001) postoperatively. No association between the change in intraocular pressure and ultrasound time or effective phaco time was observed when the data were analyzed one at a time or in a multiple linear regression model. There was no association with sex, age, nuclear density, presence of pseudoexfoliation, duration of surgery, and time of ocular pressure measurement. Eyes with preoperative IOP ≥ 21 mmHg had a more significant IOP reduction after surgery (p < 0.0001) as did eyes with an anterior chamber depth <2.5 mm (p = 0.01). Conclusion: There was a decrease in intraocular pressure six months after FLACS in our study similar to that in the published literature for standard phacoemulsification. The use of ultrasound may not influence the size of the decrease, whereas the preoperative IOP and anterior chamber depth do. FLACS may be as valuable as standard phacoemulsification for cases where IOP reduction is needed postoperatively.


2021 ◽  
pp. 30-31
Author(s):  
Gargi Verma ◽  
Kishor Kumar

Purpose: To assess the association between anterior chamber depth and endothelial cell loss after phacoemulsication Material and Methods: Ninety patients were recruited for this comparative type of observational study who were further divided into 3 groups according to anterior chamber depth (ACD). All patients underwent phacoemulsication procedure and intraocular implantation. Postoperatively endothelial cell loss (ECL) was calculated by measuring percentage decrease in endothelial cell density of central cornea and regression coefcient between ACD and ECLwas assessed in each group. Results: Endothelial cell loss was signicantly higher in shallow anterior chambers to other groups and the association between ACD and ECLwas signicant only in shallow anterior chamber depth group. Conclusion: Eyes with shallow anterior chamber depth are at higher risk for endothelial cell damage and shows an association between ACD and ECLwhen compared to deep anterior chamber depth.


2021 ◽  
Author(s):  
Qiong Lei ◽  
Haixia Tu ◽  
Xi Feng ◽  
Yong Wang

Abstract Background: To create an anterior chamber depth (ACD) regression model for adult cataract surgery candidates from China, and to evaluate the distribution of their ocular biometric parameters.Methods: The ocular biometric records of 28,709 right eyes of cataract surgery candidates who were treated at Aier Eye Hospitals in nine cities from 2018 to 2019 were retrospectively analyzed. All measurements were taken with IOLMaster 700. We included patients who were at least 40 years old and were diagnosed with cataract.Results: The mean age of the patients was 68.6 ± 11.0 years. The mean values recorded were as follows: axial length (AL), 24.17 ± 2.47 mm; mean keratometry (Km) value, 44.09 ± 3.25 D; corneal astigmatism (CA), 1.06 ± 0.98 D; ACD, 3.02 ± 0.45 mm; lens thickness (LT), 4.52 ± 0.45 mm; central corneal thickness (CCT), 0.534 ± 0.04 mm; and white to white (WTW) corneal diameter, 11.64 ± 0.46 mm. The proportion of patients with long axial length (AL >25 mm) decreased with age. ACD, LT, AL, Km, WTW, and age were correlated. In the multivariate regression analysis of ACD, which included LT, AL, WTW, sex, Km, CCT, and age, there was a reasonable prediction with adjusted R2 = 0.629.Conclusions: The results show that high myopes are inclined to schedule cataract surgery at a younger age. LT and AL were found to be important factors that affect ACD. This study provides reference data for cataract patients from China.


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