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      Changes in Anterior Chamber Configuration after Cataract Surgery as Measured by Anterior Segment Optical Coherence Tomography

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          Abstract

          Purpose

          To evaluate the changes in anterior chamber depth (ACD) and angle width induced by phacoemulsification and intraocular lens (IOL) implantation in normal eyes using anterior segment optical coherence tomography (AS-OCT).

          Methods

          Forty-five eyes (45 patients) underwent AS-OCT imaging to evaluate anterior chamber configuration before and 2 days after phacoemulsification and IOL implantation. We analyzed the central ACD and angle width using different methods: anterior chamber angle (ACA), trabecular-iris angle (TIA), angle opening distance (AOD), and trabecular iris surface area (TISA) in the nasal and temporal quadrants. Comparison between preoperative and postoperative measurement was done using paired t-tests and each of the angle parameters was analyzed with Pearson correlation testing. Subgroup analyses according to the IOL and axial length were performed with a general multivariate linear model adjusted for age.

          Results

          Before surgery, the mean anterior chamber angle widths were 23.21 ± 6.70° in the nasal quadrant and 24.89 ± 7.66° in the temporal quadrant. The mean central ACD was 2.75 ± 0.43 mm. After phacoemulsification and IOL implantation, the anterior chamber angle width increased significantly to 35.16 ± 4.65° in the nasal quadrant ( p = 0.001) and 36.03 ± 4.86° in the temporal quadrant ( p = 0.001). Also, central ACD increased to 4.14 ± 0.31 mm ( p = 0.001). AOD, TISA, and TIA increased significantly after cataract surgery and showed positive correlation with ACA.

          Conclusions

          After cataract surgery, the ACD and angle width significantly increased in eyes with cataract. AS-OCT is a good method for obtaining quantitative data regarding anterior chamber configuration.

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          Most cited references36

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          Real-time optical coherence tomography of the anterior segment at 1310 nm.

          Recent advances in high-speed scanning technology have enabled a new generation of optical coherence tomographic (OCT) systems to perform imaging at video rate. Here, a handheld OCT probe capable of imaging the anterior segment of the eye at high frame rates is demonstrated for the first time. To demonstrate real-time OCT imaging of anterior segment structures. Survey of anterior segment structures in normal human subjects. Laboratory. Achieving real-time imaging of the anterior segment, satisfactory image quality, and convenience of a handheld probe. Optical coherence tomographic imaging of the anterior segment of the eyes of human subjects was performed using 1310-nm wavelength light with an image rate of 8 frames per second. Imaging trials demonstrated clear resolution of corneal epithelium and stroma, sclerocorneal junction, sclera, iris pigment epithelium and stroma, and anterior lens capsule. The anterior chamber angle was clearly visualized. Limited imaging of the ciliary body was performed. Real-time imaging of pupillary constriction in response to light stimulus was also performed. High-speed OCT at 1310-nm wavelength is a potentially useful technique for noninvasive assessment of anterior segment structures. Our results suggest that real-time OCT has potential applications in glaucoma evaluation and refractive surgery.
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            Comparison of anterior segment optical coherence tomography and ultrasound biomicroscopy for assessment of the anterior segment.

            To compare anterior segment parameters using quantitative imaging by anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM). Tertiary-care glaucoma research center. Sixty-three eyes of 63 subjects had anterior segment evaluation by AS-OCT (Visante-Zeiss) and UBM (Paradigm). Central corneal thickness (CCT), anterior chamber depth (ACD) (measured from the central corneal endothelium to the anterior lens capsule), and the peripheral iridocorneal angles (temporal and nasal) were assessed and compared. There was an excellent correlation between AS-OCT and UBM measurements for the nasal angle (r = 0.84; P<.0001), temporal angle (r = 0.86; P<.0001), ACD (r = 0.97; P<.0001), and CCT (r = 0.91; P<.0001). There was no significant difference (paired t test) between the mean ACD, CCT, and angle parameters measured by AS-OCT or UBM. The mean values of the parameters measured by AS-OCT and UBM were, respectively, as follows: nasal angle, 26.25 degrees +/- 11.0 (SD) and 28.27 +/- 11.3 degrees (P = .3); temporal angle, 25.1 +/- 11.4 degrees and 28.3 +/- 13.5 degrees (P = .15); ACD, 2.85 +/- 0.5 mm and 2.78 +/- 0.5 mm (P = .2); and CCT, 512 +/- 46 microm and 502 +/- 46 microm (P = .25). The AS-OCT images showed sharper definition of the scleral spur than the UBM images. Anterior segment optical coherence tomography and UBM can both be used for anterior segment measurements and yielded comparable results.
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              Subsurface ultrasound microscopic imaging of the intact eye.

              The authors have developed a method of obtaining images of cross sections of the intact eye at microscopic resolution. High-frequency ultrasound transducers (100 MHz) have been developed and incorporated into imaging devices. These devices are capable of producing images to a depth of 4 mm at an axial and lateral resolution approaching 20 microns. Resolution exceeds that of current combined A- and B-scan imaging devices by a factor of approximately 10. Microscopic images of ocular structures including Schlemm's canal, cornea, iris, ciliary muscles, and retina have been produced in eye bank eyes. These studies show the feasibility of developing an apparatus to be used in the clinical setting for examining anterior structures of the eye not visible by current techniques.
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                Author and article information

                Journal
                Korean J Ophthalmol
                KJO
                Korean Journal of Ophthalmology : KJO
                The Korean Ophthalmological Society
                1011-8942
                2092-9382
                April 2011
                11 March 2011
                : 25
                : 2
                : 77-83
                Affiliations
                [1 ]Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
                [2 ]Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
                Author notes
                Corresponding Author: Ki Ho Park, MD. Department of Ophthalmology, Seoul National University College of Medicine, #103 Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: 82-2-2072-2438, Fax: 82-2-741-3187, kihopark@ 123456snu.ac.kr
                Article
                10.3341/kjo.2011.25.2.77
                3060397
                21461218
                5b47e946-c609-4baf-8faa-53703ae712b1
                © 2011 The Korean Ophthalmological Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 February 2009
                : 26 August 2010
                Categories
                Original Article

                Ophthalmology & Optometry
                tomography,anterior chamber,cataract extraction,optical coherence
                Ophthalmology & Optometry
                tomography, anterior chamber, cataract extraction, optical coherence

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