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First Author: M.Elbasty EGYPT
Co Author(s): A. Elkateb M. Metwally S. Hasan
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To quantitatively assess effect of cataract extraction on anterior segment of the eye using imaging modalities as Pentacam and AS- OCT before and after phacoemulsification and intraocular lens implantation in patients with potential risk angle closure ( angle closure suspects )
Kasr eleini hospital, Cairo university, Cairo, Egypt
Interventional prospective non-randomized study. The study enrolled 40 eyes. All patients recruited had non-complicated cataract with occludable angles (grade I, II using Shaffer grading system) in at least three quadrants. All patients completed an ophthalmologic examination including best-corrected visual acuity and manifest reỲfraction, slit-lamp biomicroscopy, Goldmann applanation tonometry, gonioscopy, and indirect ophthalmoscopy. AS-OCT (Optovue Inc., Fremont, CA, USA, software version 6,7,2,94) and Scheimpflug (Pentacam, Oculus Inc., software version 1.11) were used preoperative and three months postoperative.
Parameters obtained by Pentacam showed the following: The mean increase in anterior chamber volume (ACV) was 55.64 +/- 18.47 mm3. The mean increase in internal anterior chamber depth (ACD) was 2.06 +/- 0.37 mm. There was a significant correlation (p < 0.001) between ACD calculated using pentacam before surgery and Gonioscopic grading for both temporal, and nasal quadrants. Parameters measured by AS-OCT before and 3 months after surgery showed statistically significant increase in all parameters including angles in degrees with mean increase of 21.3 +/- 3.6 for nasal quadrant and 22.08 +/- 4.5 for temporal quadrant , angle opening distance 500 (AOD500) showed mean increase of 272 +/- 47 um for nasal and 279 +/- 65 um for temporal, and trabecular iris space area 500(TISA500) also showed mean increase of 0.058 +/- 0.093 mm2 for nasal and 0.083 +/- 0.023 mm2 for temporal quadrant. Preoperative nasal ACA, AOD500 and TISA500 using AS-OCT showed significant correlation with nasal gonioscopic grading. There was also significant correlation between temporal ACA, AOD500, TISA500 and temporal Gonioscopic grading.
Lens extraction is considered an effective treatment option for patients with angle closure suspects.