Structural changes in anterior segment after phacoemulsification combined with intraocular lens implantation and correlation analysis

Abstract

AIM: To investigate the structural changes in anterior segment of cataract patients after phacoemulsification combined with intraocular lens(Phaco+IOL)implantation, and to analyze theirs correlation.METHODS: Retrospective case study. A total of 44 cases(88 eyes)of cataract patients who underwent Phaco+IOL surgery at ophthalmology department of the Peking University Third Hospital from January 2018 to December 2022 and consented to pre- and postoperative ultrasound biomicroscopy(UBM)were included. Patients' sex, age, axial length, corneal curvature, and IOL parameters were collected. UBM was utilized to measure various anterior segment parameters pre- and post-surgery, including anterior chamber depth(ACD), scleral ciliary process angle(SCPA), iris-lens contact distance(ILCD), maximum ciliary body thickness(CBTmax), and ciliary body thickness at 0 mm from the scleral spur(CBT0). The posterior chamber area(PCA)was calculated using Image J software.RESULTS: Significant increases in ACD 3.50(2.89, 3.68)mm, CBTmax 1.199±0.233 mm, CBT0 1.11(0.964, 1.23)mm, and PCA 1.21(0.926, 1.57)mm2 were identified postoperatively compared with preoperative values(all P<0.001). The postoperative ILCD was significantly reduced to 0.00(0.00, 0.794)mm(P<0.001). There was no significant change in the postoperative SCPA 37.9°(33.4°, 46.6°; P=0.908). The increase in PCA varied significantly between genders(P=0.045), with males showing a greater mean postoperative increase(0.679 mm2)than females(0.304 mm2). Age significantly correlated with postoperative SCPA, CBTmax, and CBT0(P=0.002, 0.004, 0.009, respectively).CONCLUSION: Phaco+IOL surgery resulted in an enlargement of the PCA, significant increases in ACD, CBTmax, and CBT0, and a reduction in ILCD. The post-surgery increase of PCA was influenced by multiple factors, with age, preoperative ACD and SCPA being positively correlated, and preoperative CBT0 being negatively correlated. No significant differences were observed in the impact of different IOL brands on the structural changes of the anterior segment.

Keywords

• cataract
• anterior segment
• phaco+iol
• posterior chamber area
• ciliary body thickness