Elsevier

Ophthalmology

Volume 117, Issue 12, December 2010, Pages 2301-2307
Ophthalmology

Original article
Anterior Segment Variations with Age and Accommodation Demonstrated by Slit-Lamp–Adapted Optical Coherence Tomography

Presented as E-poster at: International Society of Refractive Surgery/American Academy of Ophthalmology, October 2009, San Francisco, California (100864).
https://doi.org/10.1016/j.ophtha.2010.03.027Get rights and content

Objective

To investigate anterior segment variations with age and accommodation by slit-lamp–adapted optical coherence tomography (SL-OCT) and determine a safe central vault distance between the implantable contact lens (ICL) and the crystalline lens to avoid contact cataract formation.

Design

Evaluation of diagnostic test or technology.

Participants

Eighty-six patients (126 eyes) under regular review from the Optometry Clinic and Outpatient Department in Zhongshan Ophthalmic Center.

Methods

Patients underwent anterior segment measurements, such as anterior chamber depth (ACD), anterior chamber width (ACW), crystalline lens rise (CLR), and pupil diameter (PD), with the SL-OCT system manufactured by Heidelberg Engineering GmbH, Heidelberg, Germany. Data were analyzed with SPSS software (version 16.0, SPSS, Inc., Chicago, IL).

Main Outcome Measures

Anterior segment parameters and their variations with age and accommodation.

Results

The internal vertical ACW (V-ACW) was anatomically larger than the internal horizontal ACW (H-ACW). With age, the ACD decreased approximately 17 μm per year. Forward movement of the crystalline lens' anterior pole decreased approximately 11 μm per year. During physiologic accommodation, the variation in ACD was −24 μm per diopter and the alterations in CLR were 28 μm per diopter. According to our data, a safe lens vault after phakic intraocular lens implantation should be more than 300 μm to reduce complications.

Conclusions

Slit-lamp–adapted optical coherence tomography is a user-friendly instrument for evaluating the anterior segment, especially for accurate anterior chamber biometry, and may offer guidance on minimizing touch and cataract formation after phakic intraocular lens implantation.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Subjects and Methods

This study was supported through a cooperative agreement with the Optometry Clinic and Outpatient Department of Zhongshan Ophthalmic Center in Guangzhou, China. The protocol and informed consent forms were reviewed and approved by the institutional review board/ethics committee of the Sun Yat-sen University, and a written informed consent form was given to each study participant. The study was conducted in accordance with the Declaration of Helsinki and the ethical standards of the local ethics

Anterior Chamber Width

The mean H-ACW and V-ACW were recorded (Table 2). To further statistically analyze H-ACW and V-ACW, a paired t test was performed between them and significant differences were found (t = 4.737, P = 0.000). The mean value of V-ACW was 0.16 mm larger than H-ACW. However, variation of ACW did not seem to depend on age, although ACW was found to be smaller in older subjects (>40 years), but this was not significant.

Anterior Chamber Depth

The mean unaccommodated ACD was also measured (Table 2). The relationship between

Discussion

Surgical correction of high ametropia is still a challenging and controversial issue. Implantation of pIOLs is an emerging technology for the treatment of high ametropia. However, pIOLs have inherent advantages and unique potential complications. The major concerns with pIOLs are their intraocular positions and how they will interact with anterior segment structures (e.g., anterior chamber angle, corneal endothelium, and crystalline lens). However, it is well known that the geometry of the

References (24)

  • K.J. Hoffer

    Biometry of 7,500 cataractous eyes

    Am J Ophthalmol

    (1980)
  • S.A. Strenk et al.

    The mechanism of presbyopia

    Prog Retin Eye Res

    (2005)
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    Manuscript no. 2009-1282.

    Drs. Yan and Lin contributed equally to this work.

    Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Supported by National Natural Science Foundation of China (30471851), Guangdong Provincial Science and Technology program (2005B30901006, 2008B060600026, and 2009B060700089), Cataract Team Program Foundation and Youth Innovation (QN-09, Haotian Lin) Foundation of State Key Laboratory of Ophthalmology.

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