Measuring Sulcus Opening Dimensions Post Cataract Surgery : An Exploratory Study

To evaluate sulcus opening dimensions in glaucomatous eyes that have undergone phacoemulsification.

Sulcal dimensions in the eye is an aspect that has been relatively understudied. As an exploratory study, we used anterior segment optical coherence tomography to assess the opening distances between the posterior edge of the iris to the anterior edge of the intraocular lens. We compared these findings between 2 independant observers to establish the reliability between results. 

44 eyes with either primary open angle glaucoma (POAG) or primary angle closure glaucoma (PACG) underwent routine phacoemulsification. Anterior segment optical coherence tomography (AS-OCT) scans of these 44 eyes were evaluated. The sulcus opening dimension, defined as the distance between the posterior aspect of the iris edge to the anterior aspect of the intraocular lens (IOL) was manually measured using proprietary software. These dimensions were measured in 4 quadrants, and by two independent graders. Mean dimensions and variances between graders were reported in each quadrant, and reliability between graders was calculated by means of intraclass coefficients.

44 eyes underwent routine phacoemulsification. 25 eyes (56.8%) were diagnosed with POAG and 19 eyes PACG (43.2%). Following phacoemulsification, the mean sulcus opening dimensions were 586.84 ± 181.69 mm (temporally), 577.02 ± 178.90 mm (nasally), 603.03 ± 180.34 mm (superiorly) and 610.25 ± 178.83 mm (inferiorly) respectively. Intraclass correlations between graders were in the temporal (0.79) and nasal (0.82) quadrants, and moderate in the superior (0.73) and inferior (0.74) quadrants respectively.

This is a novel exploratory study evaluating sulcus opening dimensions in post phacoemulsification eyes. Under optimized image acquisition, AS-OCT is a reliable and reproducible tool to aid measurements of the sulcus opening dimension. This potentially sets the groundwork for future exploration into further detailed study of sulcus dimensions, and even potential applications in sulcus introduced devices.