Quadrant-Based Evaluation Of The Lens Thickness-To-Anterior Chamber Depth Ratio As A Determinant Of Anterior Chamber Angle Width In Cataract Candidates
Published 2026 - 44th Congress of the ESCRS
Reference: PP19.12 | Type: Free paper | DOI: 10.82333/ss75-as77
Authors: Dr Zeynep Gizem Bayram* 1 , Dr Semih Çakmak 1
1Department of Ophthalmology,Istanbul Faculty of Medicine, Istanbul University,Istanbul,Türkiye
Purpose
To evaluate the relationship between the lens thickness to anterior chamber depth ratio (LT/ACD) and anterior chamber angle width (ACAW) across four quadrants; nasal, temporal, superior, and inferior in cataract surgery candidates. To determine whether LT/ACD represents an independent biometric parameter for identifying angle narrowing after accounting for axial length and corneal characteristics.
Setting
Single-center retrospective study conducted at the Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University,( Istanbul, Türkiye) a tertiary referral center, evaluating preoperative cataract candidates using optical biometry (IOLMaster 700, Carl Zeiss Meditec) and Scheimpflug tomography (Pentacam AXL, Oculus, Germany).
Methods
A total of 88 eyes with available preoperative measurements were included in the study. Lens thickness (LT), anterior chamber depth (ACD), axial length (AL), white-to-white (WTW), central corneal thickness (CCT), and total keratometry (TK1, TK2) values were recorded. Anterior chamber angle width was measured in four quadrants: nasal, temporal, superior, and inferior. The LT/ACD ratio was calculated. The effects of LT/ACD, AL, age, sex, WTW, CCT, TK1, and TK2 on anterior chamber angle width (ACAW) were evaluated using regression analysis.
Results
The mean age of the patients was 68.14 ± 10.23 years,with 43 females (48.9%) and 45 males (51.1%). The LT/ACD ratio showed a significant negative correlation with anterior chamber angles in the nasal (r = -0.693,p = 0.000), temporal (r = -0.647,p = 0.000), inferior (r = -0.472,p = 0.000), and superior (r = -0.377,p = 0.000) quadrants. A 1-unit increase in LT/ACD corresponded to an approximate narrowing of 17°, 16°, 12°, and 11° in the nasal, temporal, inferior, and superior angles, respectively. LT/ACD showed a weak but significant association with central corneal thickness (p = 0.049) and a negative correlation with axial length (p < 0.001), while no significant association was found with keratometry values (TK1: p = 0.252; TK2:p = 0.077).
Conclusions
The LT/ACD ratio may represent a clinically relevant determinant of anterior chamber angle width in cataract surgery candidates. Quadrant-based analysis indicated that LT/ACD could be associated with a consistent segmental influence on angle configuration, with relatively greater narrowing observed in the nasal and temporal quadrants. These findings may suggest that LT/ACD has the potential to function as a practical biometric parameter for identifying eyes with a higher tendency toward angle narrowing, independent of corneal curvature characteristics.