ESCRS - PP02.01 - Predictive Capacity Of The Anterior Chamber Depth In The Development Of Corneal Edema After Phacoemulsification

Predictive Capacity Of The Anterior Chamber Depth In The Development Of Corneal Edema After Phacoemulsification

Published 2022 - 40th Congress of the ESCRS

Reference: PP02.01 | Type: ESCRS 2022 - Posters | DOI: 10.82333/2hep-fb82

Authors: Celeste Briceno Lopez* 1 , Neus Burguera-Giménez 1 , Amparo Díez-Ajenjo 2 , Mª José Luque-Cobija 2 , MªCarmen García-Domene 2 , Cristina Peris-Martínez 3

1Cathedra Alcon-FISABIO-UVEG. Cornea and Anterior Segment Unit,FISABIO Medical Ophthalmology,Valencia,Spain;Department of Optics and Vision Sciences,University of Valencia,Burjassot,Spain, 2Department of Optics and Vision Sciences,University of Valencia,Burjassot,Spain;Cathedra Alcon-FISABIO-UVEG. Cornea and Anterior Segment Unit,FISABIO Medical Ophthalmology,Valencia,Spain, 3Surgery Unit Department of Ophthalmology,School of Medicine,Valencia,Spain;Cathedra Alcon-FISABIO-UVEG. Cornea and Anterior Segment Unit,FISABIO Medical Ophthalmology,Valencia,Spain

Purpose

To assess whether the anterior chamber depth may be a predictive factor in the development of corneal edema after cataract surgery assisted with femtosecond laser (FLACS).

Setting

UVEG Cátedra Alcon- University of Valencia. FISABIO Ophthalmology Medical Centre.

Methods

This prospective comparative study was developed with patients from FISABIO Ophthalmology Medical Centre (FOM). The sample comprised 142 subjects with senile cataracts, with LOCSIII grades from N2 to N4. The groups comprised 104 eyes and 38 eyes, for the control and experimental group, respectively. Experimental group was formed by patients who developed corneal edema (CE) after phacoemulsification. Dense cataracts (>N4), systemic pathologies and any corneal pathological condition were excluded from the study. Anterior chamber depth (ACD) was measured using SS Optic Coherence Tomography IOLMaster® 700 (Carl Zeiss Meditec; Jena, Alemania). Phacoemulsification was assisted by FLACS using 60kHz IntraLase® (IntraLase, IntraLase Corp.). 

Results

Kolmogorov-Smirnov test revealed the sample followed a non-parametric distribution (p<0,05). Mean age was 72,9±8,1 and 75,2±8,4 years, control and experimental group respectively. Average ACD and AXL were, for the control group 3,07±0,30 mm and 23,28±1,15 mm, and 3,04±0,33 mm and 23,40±1,19 mm for the edematic group. Sensitivity and specificity were determined employing the non-parametric Receptor Operative Curve (ROC). The ROC curve aimed to evaluate the predictive capacity of the ACD in the onset of CE after FLACS. The area under the curve (AUC) suggested that the predictive power of ACD is not enough to be used as a single predictor for CE (AUC=0,518; p=0,732) and a false positive ratio of 73,2% for a 65% of sensitivity. 

Conclusions

Anterior chamber depth has been described as a risk factor in the development of corneal edema after phacoemulsification during cataract surgery since the manipulation space is narrower. Furthermore, the endothelial cell loss related to corneal edema onset is directly related to mechanical trauma due to a repeatedly corneo-lenticular contact as had been described in previous investigations. This relationship between endothelial cell loss and anterior chamber depth led us to question whether the latter could be a predictive factor in the onset of postsurgical edema. The ROC curve showed that the diagnostic capacity in the edema onset is untrustworthy since the false positive ratio is higher than the sensitivity.