Iridocorneal angle changes measured by anterior segment optical coherence tomography in narrow angle patients after phacoemulsification with intraocular lens implantation

摘要

Purpose: Measure the iridocorneal characteristics with anterior segment optical coherence tomography before and after phacoemulsification with intraocular lens implantation in patients with cataract and narrow angle or primary angle closure glaucoma (PACG). Methods: Prospective, longitudinal, experimental case series of patients diagnosed with cataract and narrow angle or PACG in which phacoemulsification with intraocular lens implantation was performed. Iridocorneal angle measurement was performed with anterior segment optical coherence tomography (AS-OCT RTVue Optovue, Fremont, CA, USA) before cataract surgery and after one month. The measurements with OCT were: iridocorneal angle, angle opening distance at 500 and 750 ?μm (AOD 500-750), trabecular-iris space area at 500 and 750 ?μm (TISA 500-750) and angle recess area (ARA). We also evaluated best-corrected visual acuity (BCVA), intraocular pressure (IOP) and gonioscopy with Shaffer grade system and lens opacity with LOCS III before and after phacoemulsification. Results: We included 12 eyes (10 patients), 12 were female (100%), mean age of 74.67 years (?± 6.41), 9 patients diagnosed with narrow angle and 3 with PACG. Before surgery we found a mean BCVA in LogMAR 0.34 (?± 0.10), refraction of +2.39 (?± 2.13), Shaffer grade system between 0-2 and antero-posterior axis of 22.66 (?± 0.81). In the measurements made by OCT: iridocorneal angle, AOD 500-750, TISA 500-750 and ARA after phacoemulsification we found a statistically significant (p0.05) increase that correlated with gonioscopy (Shaffer 2-4). IOP was not significantly changed before and after phacoemulsification in any patients. Conclusions: Phacoemulsification with intraocular lens implantation significantly modifies iridocorneal angle anatomy, increasing its dimensions. The OCT is a noncontact instrument that allows us to analyze these changes objectively. Studies with longer follow-up are needed to confirm our long-term results.