The Relationship Between Modulations In Anterior Chamber Depth And Refraction After Routine Cataract Surgery

Published 2022 - 40th Congress of the ESCRS

Reference: FPM01.09 | Type: Free paper | DOI: 10.82333/7f5s-2d30

Authors: Larysa Tutchenko* ¹ , Sudi Patel ² , Mykhailo Skovron ¹ , Oleksiy Voytsekhivskyy ¹

¹Kyiv City Clinical Ophthalmological Hospital,Eye Microsurgery Center,Kyiv,Ukraine, ²NHS National Services Scotland,NHS National Services Scotland,Stirling,United Kingdom

Purpose

To explore the significance of any relationshipbetween changes in anterior chamber depth (ΔACD) and alterations in refraction following uneventful routine phacoemulsification in patients with clear unremarkable corneas.

Setting

Kyiv City Clinical Ophthalmological Hospital, Eye Microsurgery Center, Kyiv, Ukraine

Methods

Anterior chamber depth (ACD, mm), checked with IOLMaster700 to assess the location of the IOL along the antero-posterior axis, and objective refraction values were monitored between one and two months postop following routine phacoemulsification with nontoric IOL implantation.Refractive data were subjected to Cartesian vector analysisusing Thibos’ method to determine the Jo, J45 and B values.All surgeries were performed under topical anaesthesia (2.2mm incision at 12o’clock), postop injection of dexamethasone (subconjunctival) and betamethasone (parabulbar), topical levofloxacin, oftan-dexamethason, indomethacin, dexpanthenol, trehalose and hyaluronic acid.

Results

In 86 cases (1eye/patient) there was no significant change in either mean ACD or sphere (p>0.05) but the mean[±sd] cylinder changed from -1.29DC [±0.89] to -1.12DC[±0.69] (t-test, p=0.021). Significant associations were revealed between ΔACD (x) & change in i) Jo (ΔJo), ii) J45(ΔJ45) iii) B (ΔB); and ACD at 1 month. These associationsare best described by

1) ΔJo =1.025x3-2.159x2+1.330x-0.348 (r=0.285, n=86,p<0.01)

2) ΔJ45= 2.403x2-1.072x3-1.2730x+0.085 (r=0.248, n=86,p=0.021)

3) ΔB =2.943x4 - 10.745x3+12.74x2-5.127x-0.118 (r=0.220, n=86, p=0.043)

4) x = 0.63ACD -2.87 (r=0.429, n=86, p<0.01).

Conclusions

Changes in objective refraction correlate with alterations in ACD following uneventful routine phacoemulsification. These changes are mainly astigmatic not spherical. This suggests that other factors such as tilt or dislocation of the IOL, along the X-Y axes parallel to Listing’s plane, accompanying changes in ACD play a role in affecting postop astigmatism.