Anterior Lens Curvature As A Presic Of Zonular Instability
Published 2025 - 43rd Congress of the ESCRS
Reference: PP04.07 | Type: Free paper | DOI: 10.82333/q2ye-3331
Authors: Michael Tsatsos 1 , Dimitra Tzakri* 1 , Argyrios Tzamalis 1 , Nikolaos Ziakas 1
1IInd Ophthalmology Department ,Aristotle University of Thessaloniki ,Thessaloniki ,Greece
Purpose
To measure anterior lens curvature preop and determine any correlation to zonular instability
Setting
Refractive surgery clinic and academic setting.
Methods
Anterior segment OCT imaging was obtained preoperatively and intraopeeqtive zonular instability was recorded as was use of capsular support measures. The anterior curvature of the lens was calculated from the OCT. Zonular stability was assessed intraoperatively and over a minimum of 24 months follow up postoperatively.
it was a consecutive prospective study.
Results
A total of 178 eyes completed the study. 26/178 eyes had anterior lens curvature >9.15 mm and a lens apex at least 1.5 mm above the pupil plane (P<.01). The remaining eyes had an average anterior lens curvature of 8.72 mm.The 26 eyes showed intraoperative zonular instability requiring the placement of a Capsular tension ring (CTR). 1/26 required the placement of a sutured capsular tension segment (CTS) as well. In the latter's case the anterior lens curvature was 9.5 mm and the lens apex 2.2 mm above the pupil plane. Over the 24 months follow up a further 3/26 eyes required IOL complex to sclera suture fixation.
Preoperative SLE suggested possible zonular issues (shallower posterior chamber, hint of phacodonesis) in 18/26 eyes..
Conclusions
Determine the pre operative anterior lens curvature can help to predict zonular issues and plan surgery better. An anterior lens curvature of 9.15 mm and an anterior lens apex at least 1.5 mm anterior to pupil plane are preliminary reference markers to predict significant issues and might help to plan surgery better. The majority of cases showed suggestive findings on preoperative slit lamp examination.