Changes in Anterior Segment Morphology and Intraocular Pressure after Cataract Surgery in Non-glaucomatous Eyes

Abstract

Background It is known that cataract extraction is associated with a significant reduction in intraocular pressure, especially in narrow angled eyes; however, the modifications of anterior segment parameters associated with this phenomenon have still not been completely defined. The purpose of this study was to evaluate changes in anterior segment anatomy and intraocular pressure after cataract surgery in non-glaucomatous eyes.

Methods and Material This retrospective case series study included 64 eyes of 64 consecutive patients who underwent phacoemulsification with intraocular lens implantation. Anterior segment parameters and intraocular pressure were assessed and compared before and 6 months after surgery. Anterior segment imaging was performed using Casia SS-1000 anterior segment optical coherence tomography (Tomey, Nagoya, Japan). Anterior segment measurements included anterior chamber depth, anterior chamber width, anterior chamber volume, angle opening distance at 500 µm anterior to the scleral spur, angle recess area 750 µm from the scleral spur, lens vault, trabecular iris space area at 500 µm from the scleral spur, and trabecular iris angle at 500 µm from the scleral spur. Intraocular pressure was measured using the Goldmann applanation tonometer (Model AT 900 C/M, Haag-Streit, Bern, Switzerland). Anterior segment parameters and the relationship of changes in intraocular pressure were also evaluated.

Results All anterior segment parameters increased significantly after surgery (p < 0.05). Both angle opening distance at 500 µm anterior to the scleral spur and anterior chamber depth changes were positively correlated with the preoperative lens vault. The mean intraocular pressure significantly decreased from 14.91 mmHg (± 2.8 SD) to 12.91 mmHg (± 3.13 SD) (p < 0.001). Changes in intraocular pressure correlated negatively with values for the width of the preoperative anterior chamber (r = − 0.533; p = 0.001).

Conclusion Cataract surgery led to significant widening of the anterior chamber angle and lowering of intraocular pressure. Further investigations are needed to better understand whether anterior chamber width may be a new independent predictive factor for reduction in postoperative intraocular pressure.

Zusammenfassung

Hintergrund Es ist bekannt, dass die Kataraktextraktion mit einer signifikanten Senkung des Augeninnendrucks einhergeht, insbesondere bei engen Augenwinkeln; die mit diesem Phänomen verbundenen Modifikationen der Parameter des vorderen Segments sind jedoch noch nicht vollständig definiert. Der Zweck dieser Studie war es, Veränderungen in der Anatomie des vorderen Augenabschnitts und des Augeninnendrucks nach einer Kataraktoperation bei nicht glaukomatösen Augen zu bewerten.

Methoden und Material Diese retrospektive Fallserienstudie umfasste 64 Augen von 64 konsekutiven Patienten, die sich einer Phakoemulsifikation mit intraokularer Linsenimplantation unterzogen haben. Die Parameter des vorderen Segments und der Augeninnendruck wurden vor und 6 Monate nach der Operation bewertet und verglichen. Die Bildgebung des vorderen Segments wurde unter Verwendung des optischen Kohärenztomographen Casia SS-1000 (Tomey, Nagoya, Japan) durchgeführt. Die Messungen des vorderen Segments umfassten Vorderkammertiefe, Vorderkammerbreite, Vorderkammervolumen, Winkelöffnungsabstand bei 500 µm vor dem Skleralsporn, Winkelaussparungsbereich 750 µm vom Skleralsporn, Linsengewölbe, trabekulärer Irisraumbereich bei 500 µm von der Skleralsporn und trabekulärer Iriswinkel bei 500 µm vom Skleralsporn. Der Augeninnendruck wurde unter Verwendung eines Goldmann-Applanationstonometers (Modell AT 900 C/M; Haag-Streit, Bern, Schweiz) gemessen. Die Beziehung zwischen den Parametern des vorderen Segments und den Veränderungen des Augeninnendrucks wurde ebenfalls bewertet.

Ergebnisse Alle Vorderabschnittsparameter stiegen nach der Operation signifikant an (p < 0,05). Sowohl „Winkelöffnungsabstand bei 500 µm anterior zum Skleralsporn“, als auch Veränderungen der Vorderkammertiefe waren positiv mit der präoperativen Linsenwölbung korreliert. Der mittlere Augeninnendruck sank signifikant ab, von 14,91 mmHg (± 2,8 SD) auf 12,91 mmHg (± 3,13 SD) (p < 0,001). Veränderungen des Augeninnendrucks korrelierten negativ mit präoperativen Vorderkammerweitenwerten (r = − 0,533; p = 0,001).

Schlussfolgerung Die Kataraktoperation führte zu einer deutlichen Aufweitung des Vorderkammerwinkels und einer Senkung des Augeninnendrucks. Weitere Untersuchungen sind erforderlich, um besser zu verstehen, ob die Vorderkammerbreite ein neuer unabhängiger prädiktiver Faktor für die postoperative Augeninnendrucksenkung sein könnte.

Key words

intraocular pressure - cataract surgery - anterior segment OCT - anterior segment morphology

Schlüsselwörter

Augeninnendruck - Kataraktchirurgie - Vorderabschnitt-OCT - Morphologie des vorderen Segments

Publication History

Received: 16 September 2022

Accepted: 03 January 2023

Article published online:
25 April 2023

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