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AIM: To investigate the characteristics of anterior segment structure in first-degree relatives of patients with primary angle-closure glaucoma(PACG).METHODS: A total of 48 first-degree relatives of PACG patients aged 40-60 who were treated in the Affiliated Eye Hospital of Nanchang University from September 2020 to October 2022 were selected as the observation group. Additionally, 40 cases(40 eyes)of healthy individuals without glaucoma and family history of glaucoma at the same age group were collected as the control group. They were divided into younger group(40-49 years old)and elder group(50-60 years old). All subjects were examined with ultrasound biomicroscopy(UBM)and were measured using camera measure software. The parameters mainly included anterior chamber depth(ACD), anterior chamber area(ACA), anterior chamber width(ACW), anterior segment depth(ASD), angle open distance(AOD500), trabecular iris angle(TIA), trabecular iris area(TISA500), lens vault(LV), iris curve(IC), iris thickness(IT500), scleral ciliary process angle(SCPA), and iris ciliary process distance(ICPD).RESULTS: ACD, ACA, AOD500, TISA500 and TIA in the observation group were lower than those of the control group, and LV and IC were higher than those of the control group(all P<0.05). ACD, ACA, AOD500, TISA500, and TIA of the elder group were lower than those in the age-matched control group, while LV and IC were larger than those of the age-matched control group(all P<0.05). ACD, AOD500, TISA500, and TIA of the younger observation group were smaller than those of the age-matched control group, but LV and IC were significantly larger than those of the age-matched control group(all P<0.05). ACD, ACA, AOD500, TISA500 and TIA of the elder observation group were significantly lower than those of the younger observation group, and LV and IC were significantly larger than those of the younger observation group(all P<0.05). There was a difference in the distribution of ACD between the observation group and the control group(P<0.05), and the proportion of moderate to severe shallow anterior chambers was 10 times that of the control group. Correlation analysis showed that TISA500 was positively correlated with ACD and ACA, and negatively correlated with LV and IC, and TISA500 was mainly influenced by LV. IC had a positive correlation with LV and a negative correlation with ACD and ACA.CONCLUSION: First-degree relatives of PACG with normal axial length have a high risk of angle closure. The anterior segment structures of first-degree relatives of PACG are more crowded than normal individuals, and the lens forward shift may be the initial influencing factor for narrow angle.
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AIM:To evaluate the correlation between axial lengths and anterior segment parameters using swept-source optical coherence tomography(SS-OCT).METHODS:For the cross-sectional clinical study, a total of 109 adult volunteers with different degrees of myopia recruited from January 1, 2022, to March 31, 2022, at the ophthalmology clinic of the First Affiliated Hospital of Zhengzhou University were included. Participants were divided into 4 groups based on axial length(AL): group A(AL≤24.0mm), group B(24.0mm<AL≤25.0mm), group C(25.0mm<AL≤26.0mm)and group D(AL>26.0mm). Anterior segment examinations were performed using SS-OCT, including: central corneal thickness(CCT), lens thickness(LT), anterior chamber depth(ACD), anterior chamber width(ACW), angle opening distance(AOD500), angle recess area(ARA500), trabecular iris space area(TISA500), trabecular iris angle(TIA500), crystalline lens rise(CLR). The relationships between these data and AL, spherical equivalent(SE)were analyzed.RESULTS:There was no difference in the comparison of CCT among the four groups(P>0.05). There were differences in SE, LT, ACD, ACW, AOD500, ARA500, TISA500, TIA500 and CLR among the four groups(all P<0.01). SE and LT were negatively correlated with AL(r=-0.75, -0.41, all P<0.01); ACD, ACW and CLR were positively correlated with AL(r=0.58, 0.45, 0.54, all P<0.01); AOD500, ARA500, TISA500 and TIA500(temporal and nasal side)were positively correlated with AL(all P<0.01). ACD and CLR were negatively correlated with SE(r=-0.21,-0.25, all P<0.01), and LT was positively correlated with SE(r=0.21, P<0.05).CONCLUSION:As AL increases, CCT remains unchanged while the ACD and ACW increase. The position of the crystalline lens moves backward and LT decreases.
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With the development of posterior chamber phakic intraocular lenses implantation and the constant improvement of the implantable collamer lens(ICL), ICL V4c implantation has become one of the main methods for correcting moderate and high myopia. Vault is an important indicator to evaluate the security of posterior chamber intraocular lens implantation. In recent years, optimizing surgical procedures to obtain the ideal vault in ICL V4c implantation surgery has become a research hotspot. This paper aims to provide help for improving surgical safety by summarizing and analyzing the optimized programs of ICL V4c implantation surgery. The focus will be on preoperative examination, intraoperative surgical design, and postoperative follow-up.
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AIM:To observe the early variation trend of the vault after phakic posterior chamber implantable collamer lens/toric implantable collamer lens(ICL/TICL V4c)implantation and analyze the related influencing factors.METHODS:In this retrospective study, a total of 49 patients(98 eyes)who underwent ICL/TICL V4c implantation in the Lanzhou Huaxia Eye Hospital from October 2020 to March 2021 were enrolled. Preoperative ocular biometric parameters were collected, including spherical equivalent(SE), intraocular pressure, axial length, anterior chamber depth(ACD), lens thickness(LT), central corneal thickness, anterior chamber angle(ACA), anterior chamber volume(ACV), white to white corneal diameter(WTW), mean keratometry K1 and K2, and intraoperative implantation size of ICL. The vault was measured by anterior segment optical coherence tomography(AS-OCT)at 1, 3d, 1wk and 1mo after surgery. The patients were divided into insufficient vault group(<250μm, 12 eyes), normal vault group(250-750μm, 62 eyes)and excessive vault group(>750μm, 24 eyes)according to the vault at 1mo after surgery. The factors affecting the postoperative vault were analyzed.RESULTS:The mean vault values at 1 and 3d, 1wk and 1mo after surgery were 591.05±293.44, 599.62±309.78, 592.22±301.49 and 586.69±285.63μm, respectively. There were significant differences in WTW, ACA, ACV, ACD, ICL size and LT at 1mo after surgery(all P<0.05). The regression equation of vault at 1mo after surgery was as follows: vault(μm)=-3142.19+388.25×WTW+10.40×ACA-301.63×LT(R=0.674, R2=0.454, adjusted R2=0.436). WTW had the greatest influence on vault at 1mo after surgery(β=0.47, P<0.001), followed by LT(β=-0.34, P<0.001)and ACA(β=0.17, P=0.047).CONCLUSION:WTW, ACA and LT were the main factors that affected and predicted the vault at 1mo after ICL/TICL V4c implantation.
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@#AIM:To compare the difference, correlation and consistency of corneal biological parameters measured by IOL Master 700 and Pentacam before cataract extraction and intraocular lens implantation in different age groups.<p>METHODS: Cross-sectional study. A total of 87 cataract patients(162 eyes)in Weifang Eye Hospital from February to September 2020 were collected, including 44 males(80 eyes)and 43 females(82 eyes)(age 61.2±9.87 years). The patients were divided into four groups: group A \〖17 cases(32 eyes), 40-50 years old\〗, group B \〖25 cases(47 eyes), 51-60 years old\〗, group C \〖28 cases(53 eyes), 61-70 years old\〗, and group D \〖17 cases(30 eyes), 71-80 years old\〗. The preoperative corneal biological parameters of cataract patients were measured by IOL Master 700 and Pentacam, and the flat axis corneal curvature(K1), steep axis corneal curvature(K2), mean corneal curvature(Km), corneal astigmatism, anterior chamber depth(ACD)and central corneal thickness(CCT)were recorded. The difference and correlation of measurement results between two kinds of biometric instruments in different age groups were analyzed. <p>RESULTS: Except for the corneal astigmatism in group C and K1 and corneal astigmatism in group D, there were significant differences between the two instruments(<i>t</i>=2.746, -2.582, 2.637, all <i>P</i><0.05), but there was no significant difference in other parameters among the four groups. Pearson correlation analysis showed that there was a good correlation between the two instruments in measuring the parameters of the four groups of patients. The results of Bland-Altman analysis showed that there was a good consistency between IOL Master 700 and Pentacam in measuring K1, K2, Km, corneal astigmatism, ACD and CCT in the four groups.<p>CONCLUSION:There was no significant difference between IOL Master 700 and Pentacam in the measurement of corneal biological parameters in cataract patients aged 40-60 years, but there was significant difference in astigmatism between 61-70 years old, astigmatism and K1 value in 71-80 years old patients. Pearson correlation analysis showed that there was a good correlation between the two instruments. Generally speaking, the consistency of the two kinds of examination equipment is good, and the corneal astigmatism and corneal curvature should be selected by comprehensive analysis of the data.
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@#AIM: To compare anterior segment parameters in eyes with cataracts and different axial lengths measured with Pentacam and IOL Master.<p>METHODS: This study included 170 eyes of 143 patients diagnosed as cataract at Tangdu Hospital, Air Force Medical University. For each patient, anterior segment parameters were measured before surgery with Pentacam and IOL Master system, respectively.<p>RESULTS: There were no statistically significant differences in K1 and K2 values of eyes with long axial length(<i>P</i>>0.05). And there were statistically significant differences in K2 values(<i>P</i><0.01), but not K1 values(<i>P</i>>0.05)of eyes with short and middle axial lengths. There were statistically significant differences in ACD values of eyes with any axial length(<i>P</i><0.01). The Bland-Altman showed that ACD values of eyes with any axial length and K2 values of eyes with long and middle axial lengths were both in good agreement, and K1 values of eyes with any axial length were in great agreement.<p>CONCLUSION: Pentacam and IOL Master can be interchanged for keratometry in eyes with long axial length, but the measurements of keratometry in eyes with short and middle axial lengths and ACD of eyes with any axial length should be compared in clinical application.
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PURPOSE: To compare the clinical and anterior segment anatomical features in primary angle closure sub-groups based on configurations of iris root insertion. METHODS: Primary angle closure patients were imaged using anterior segment optical coherence tomography. Anterior chamber depth, iris curvature, iris thickness (IT) at the scleral spur and 500, 750, and 1,500 µm from the scleral spur (IT(0), IT(500), IT(750), and IT(1500)), lens vault, iris area, angle opening distance (AOD(500)), angle recess area (ARA(750)), and trabecular iris space area (TISA(750)) were measured. Iris root insertion was categorized into a non-basal insertion group (NBG) and basal insertion group (BG). RESULTS: In total, 43 eyes of 39 participants belonged to the NBG and 89 eyes of 53 participants to the BG. The mean age of participants was greater in the NBG than the BG (62.7 ± 5.7 vs. 59.8 ± 7.3 years, p = 0.043), and the baseline intraocular pressure was higher in the BG than the NBG (16.4 ± 4.4 vs. 14.9 ± 3.3 mmHg, p = 0.037). The BG showed a greater IT(0) (0.265 ± 0.04 vs. 0.214 ± 0.03 mm, p < 0.001) and iris area (1.59 ± 0.24 vs. 1.52 ± 0.27 mm2, p = 0.045), lower ARA(750) (0.112 ± 0.08 vs. 0.154 ± 0.08 mm2, p = 0.017) and AOD(500) (0.165 ± 0.07 vs. 0.202 ± 0.08 mm, p = 0.014) compared to the NBG. CONCLUSIONS: The BG had a narrower anterior chamber angle, thicker peripheral iris, and higher pretreatment intraocular pressure.
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Female , Humans , Male , Middle Aged , Anterior Eye Segment/diagnostic imaging , Glaucoma, Angle-Closure/diagnosis , Gonioscopy , Intraocular Pressure , Iridectomy/methods , Iris/diagnostic imaging , Lens, Crystalline/diagnostic imaging , Prospective Studies , Tomography, Optical Coherence/methodsABSTRACT
AIM: To explore the differences of anterior segment parameters in the patients with fellow eyes of unilateral acute angle-closure glaucoma ( AACG ) , primary angle-closure suspects ( PACS) and normal group. METHODS: Twenty-six eyes of 26 patients with fellow eyes of AACG, 28 eyes of 28 age- and gender-matched PACS and 34 normal eyes were imaged using optical coherence tomography ( OCT) and pentacam scheimpflug system ( Pentacam ) . Anatomical parameters including central corneal thickness ( CCT ) , corneal volume ( CV ) , pupillary diameter ( PD ) , central anterior chamber depth ( CACD ) , peripheral anterior chamber depth ( PACD ) , anterior chamber volume ( ACV ) and anterior chamber angle ( ACA) were obtained from Pentacam. Iris thickness (IT750,IT2000), cross-sectional area (IS), volume (IV) and angle opening distance 500 (AOD500) were estimated using OCT combined with a computer image processing. Statistic analysis was performed with SPSS. RESULTS: There were no significant differences in corneal parameters (CCT, CV), PD and iris values (IT750, IT2000, IS, IV) among the three groups (P> 0. 05). Compared with the fellow eyes of AACG and PACS, normal eyes had larger ACV, wider AOD500 and ACA, deeper CACD and PACD ( P 0. 05). Using the fellow eyes of AACG as the standard to predict high risk of angle closure, areas under the receiver operating characteristic curve of the above parameters were all less than 0. 7. CONCLUSION:All the anterior segment parameters are no different significantly between the fellow eyes of AACG and PACS. They may be notaccurate criteria for determining high risk group of PACS.
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AlM: To compare the anterior segment measurements derived from optical low coherence reflectometer ( Lenstar LS900 ) and combined Scheimpflug - Placido disk topographer ( Sirius) . METHODS: ln this study, we enrolled healthy myopic subjects 54 ( 87 eyes ) . The central corneal thickness (CCT), anterior chamber depth (ACD), flat keratometry ( FK) readings , steep keratometry ( SK ) readings and white to white ( WTW ) were measured by LS900 and Sirius. Evaluation and analysis were performed using paired t tests, the Pearson correlation, and Bland-Altman analyses. RESULTS: The CCT and ACD measurements were significantly lower whereas FK, SK and WTW measurements were higher with LS900 (P CONCLUSlON: Anterior segment parameters evaluated with LS900 and Sirius systemare correlated well and achieve good agreement. However, there are significantly statistical differences which may be caused by the different measurement modes, so they may not be interchangeable use under certain clinical circumstances.
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PURPOSE: We evaluated various preoperative anterior segment parameters measured with a Pentacam rotating Scheimpflug camera and compared them with those of conventional methods. We also evaluated the effect of different parameters on corneal endothelial cells after cataract surgery. METHODS: Pentacam examination was performed in 88 eyes from 88 patients to evaluate central anterior chamber depth (ACD(pentacam)), nuclear density (Densitometry(pentacam)), anterior chamber volume (ACV), and lens thickness (LT(pentacam)). We compared values of ACD(pentacam) with those of ultrasound (ACD(sono)) and also compared Densitometry(pentacam) values with those of Lens Opacities Classification System (LOCS III) classification. We evaluated the effect of the following preoperative values measured with Pentacam on postoperative endothelial cell loss: pupil size measured both preoperatively and before capsulorrhexsis (Pupil(CCC)), amount of viscoelastics, and LT measured by ultrasound (LT(sono)). RESULTS: A significant concordance was found between the two grading methods of nuclear opacity: Densitometry(pentacam) and LOCS III classification (tau(b) = 0.414, p = 0.000). We also found a positive correlation between ACD(pentacam) and ACD(sono) (r = 0.823, p = 0.000) and between ACD(pentacam) and ACV (r = 0.650, p = 0.000). There were significant differences between the results of LT(pentacam) and LT(sono). The final regression model identified Densitometry(pentacam), viscoelastics and Pupil(CCC) as independent predictors of decreased postoperative corneal endothelial cell density (CD) at postoperative day 3, and Densitometry(pentacam), viscoelastics, and ACV as independent predictors of decreased CD two months postoperatively (p<0.05). CONCLUSIONS: Good agreement was found between all results obtained with the Pentacam and conventional methods except LT. Analyzing anterior chamber parameters preoperatively using Pentacam could be helpful to predict postoperative endothelial cell loss.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anterior Chamber/pathology , Cataract/classification , Cataract Extraction/methods , Corneal Endothelial Cell Loss/diagnosis , Linear Models , Photography/instrumentation , Predictive Value of TestsABSTRACT
PURPOSE: To compare anterior segment parameters in angle-closure glaucoma (ACG), primary open angle glaucoma (POAG), and normal subjects (N) using a Schiempflug camera. METHODS: Central corneal thickness (CCT), lens thickness (LT), axial length (AL), anterior chamber angle (ACA), anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured in ACG (93 eyes of 92 patients), POAG (90 eyes of 87 patients), and normal (91 eyes of 88 subjects) with Pentacam(R) and A-scan. All of the results and measurements were then compared. RESULTS: Compared to normal and POAG patients, ACG patients presented with significantly different measurements of CCT, LT, AL, and ACA, ACD, and ACV (p<0.05). Further, correlations were high between three measurements (ACA, ACD, ACV) in ACG, and the best correlations were found in acute angle-closure glaucoma (P<0.05). CONCLUSIONS: By using a Schiempflug camera it was possible to assess the correlation between anterior segment parameters (ACA, ACD, ACV) in glaucoma patients. The best correlations were found in acute angle-closure glaucoma, and thus anterior segment parameters can offer reciprocally complementary information.