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      The change of anterior chamber angle parameters after cataract surgery in diabetic patients

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          Abstract

          Purpose:

          The purpose of this study is to investigate the change of anterior chamber angle morphology after cataract surgery in patients with type 2 diabetes mellitus (DM2) using anterior segment optical coherence tomography (AS-OCT).

          Methods:

          In this prospective and comparative study, 57 eyes of the patients with cataract were investigated. The patients were divided into two groups. The DM2 group included cataractous type 2 diabetic patients without diabetic retinopathy ( n = 30) and the non-DM2 group included nondiabetic participants with cataract ( n = 27). The AS-OCT examinations were performed at baseline and 1 month after the cataract surgery. The corrected distance visual acuity (CDVA), intraocular pressure (IOP), angle-opening distance at 500 µm (AOD-500) and trabecular iris space area at 500 µm (TISA-500), and scleral spur angle (SSA) in temporal quadrant were analyzed.

          Results:

          The mean age, sex, and axial length values were similar in both groups ( p > 0.05 for all). The CDVA was significantly improved in both groups ( p < 0.001). The mean AOD-500, TISA-500, and SSA were increased and the mean IOP was decreased after cataract surgery in both groups ( p < 0.001 for all). There were not any statistically significant intergroup differences in CDVA, IOP, and AS-OCT measurements between the DM2 and non-DM2 groups ( p > 0.05 for all).

          Conclusion:

          Cataract surgery showed significant increases in mean anterior chamber angle parameters and reductions in IOP values in both diabetic and nondiabetic patients without intergroup significant differences. These results suggested the safety and effectiveness of cataract surgery, especially regarding anterior chamber angle parameters and so IOP changes.

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          Most cited references26

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          Anterior segment optical coherence tomography

          Optical coherence tomography (OCT) provides non-contact, rapid in vivo imaging of ocular structures, and has become a key part of evaluating the anterior segment of the eye. Over the years, improvements to technology have increased the speed of capture and resolution of images, leading to the increasing impact of anterior segment OCT imaging on clinical practice. In this review, we summarize the historical development of anterior segment OCT, and provide an update on the research and clinical applications of imaging the ocular surface, cornea, anterior chamber structures, aqueous outflow system, and most recently anterior segment vessels. We also describe advancements in anterior segment OCT technology that have improved understanding with greater detail, such as tear film in dry eye disease evaluation, intra-operative real-time imaging for anterior segment surgery, and aqueous outflow with angle assessment for glaucoma. Improvements to image processing and software have also improved the ease and utility of interpreting anterior segment OCT images in everyday clinical practice. Future developments include refinement of assessing vascular networks for the anterior segment, in vivo ultra-high resolution anterior segment optical coherence tomography with histology-like detail, en-face image with 3-dimensional reconstruction as well as functional extensions of the technique.
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            Reduction in intraocular pressure after cataract extraction: the Ocular Hypertension Treatment Study.

            To determine the change in intraocular pressure (IOP) after cataract extraction in the observation group of the Ocular Hypertension Treatment Study. Comparative case series. Forty-two participants (63 eyes) who underwent cataract surgery in at least 1 eye during the study and a control group of 743 participants (743 eyes) who did not undergo cataract surgery. We defined the "split date" as the study visit date at which cataract surgery was reported in the cataract surgery group and a corresponding date in the control group. Preoperative IOP was defined as the mean IOP of up to 3 visits before the split date. Postoperative IOP was the mean IOP of up to 3 visits including the split date (0, 6, and 12 months' with "0 months" equaling the split date). In both groups, we censored data after initiation of ocular hypotensive medication or glaucoma surgery of any kind. Difference in preoperative and postoperative IOP. In the cataract group, postoperative IOP was significantly lower than the preoperative IOP (19.8 ± 3.2 mmHg vs. 23.9 ± 3.2 mmHg; P<0.001). The postoperative IOP remained lower than the preoperative IOP for at least 36 months. The average decrease in postoperative IOP from preoperative IOP was 16.5%, and 39.7% of eyes had postoperative IOP ≥ 20% below preoperative IOP. A greater reduction in postoperative IOP occurred in the eyes with the highest preoperative IOP. In the control group, the corresponding mean IOPs were 23.8 ± 3.6 before the split date and 23.4 ± 3.9 after the split date. Cataract surgery decreases IOP in patients with ocular hypertension over a long period of time. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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              Lens vault, thickness, and position in Chinese subjects with angle closure.

              To investigate the association of lens parameters-specifically, lens vault (LV), lens thickness (LT), and lens position (LP)-with angle closure. Prospective, comparative study. One hundred two Chinese subjects with angle closure (consisting of primary angle closure, primary angle-closure glaucoma, and previous acute primary angle closure) attending a glaucoma clinic and 176 normal Chinese subjects with open angles and no evidence of glaucoma recruited from an ongoing population-based cross-sectional study. All participants underwent gonioscopy and anterior-segment optical coherence tomography (AS OCT; Carl Zeiss Meditec, Dublin, CA). Customized software was used to measure LV, defined as the perpendicular distance between the anterior pole of the crystalline lens and the horizontal line joining the 2 scleral spurs, on horizontal AS OCT scans. A-scan biometry (US-800; Nidek Co, Ltd, Tokyo, Japan) was used to measures LT and to calculate LP (defined as anterior chamber depth [ACD] +1/2 LT) and relative LP (RLP; defined as LP/axial length [AL]). Lens parameters and angle closure. Significant differences between angle-closure and normal eyes were found for LV (901±265 vs. 316±272 μm; P<0.001), LT (4.20±0.92 vs. 3.90±0.73 mm; P = 0.01), LT-to-AL ratio (0.18±0.04 vs. 0.16±0.03; P<0.001), ACD (2.66±0.37 vs. 2.95±0.37 mm; P<0.001), and AL (22.86±0.93 vs. 23.92±1.37 mm; P<0.001), but no significant differences were found for LP (4.76±0.51 vs. 4.90±0.54 mm; P = 0.34) or RLP (0.21±0.02 vs. 0.20±0.02; P = 0.14). After adjusting for age, gender, ACD, LT, and RLP, increased LV was associated significantly with angle closure (odds ratio [OR], 48.1; 95% confidence interval [CI], 12.8-181.3, comparing lowest to highest quartile), but no association was found for LT (OR, 1.78; 95% CI, 0.76-4.16), LP (OR, 1.94; 95% CI, 0.59-6.31), or RLP (OR, 2.08; 95% CI, 0.66-6.57). There was low correlation between LV and LT (Pearson's correlation coefficient [PCC], 0.17), between LV and RLP (PCC, 0.08), or between LV and LP (PCC, 0.2). Eyes with angle closure have thicker lenses with greater LV compared with normal eyes. The LV, which represents the anterior portion of the lens, is a novel parameter independently associated with angle closure after adjusting for age, gender, ACD, and LT. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Ther Adv Ophthalmol
                Ther Adv Ophthalmol
                OED
                spoed
                Therapeutic Advances in Ophthalmology
                SAGE Publications (Sage UK: London, England )
                2515-8414
                10 August 2021
                Jan-Dec 2021
                : 13
                : 25158414211034717
                Affiliations
                [1-25158414211034717]Department of Ophthalmology, Esenler Hospital, Medipol University, Birlik Mah Bahçeler cad. no:5 Esenler 34320, Istanbul, Turkey
                [2-25158414211034717]Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
                Author notes
                Author information
                https://orcid.org/0000-0003-1827-968X
                https://orcid.org/0000-0002-7443-6902
                Article
                10.1177_25158414211034717
                10.1177/25158414211034717
                8365015
                34409258
                fa0fe632-7064-4887-90e5-ba6c2cca9ae0
                © The Author(s), 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 20 February 2021
                : 6 July 2021
                Categories
                Original Research
                Custom metadata
                January-December 2021
                ts1

                anterior chamber angle parameters,anterior segment optical coherence tomography,cataract surgery,diabetes mellitus

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