Relative Anterior Microphthalmos and Shallow Anterior Chamber: Comparison of Surgical Performance and Postoperative Outcomes

Saturday, April 18, 2015: 2:10 PM
Room 5A (San Diego Convention Center)
Shail A. Vasavada, DO, DNB, FICO
Mamidipudi R. Praveen, MS
Viraj A. Vasavada, MS
Vaishali Vasavada, MS
Abhay R. Vasavada, MS, FRCS

To compare intraoperative performance and postoperative surgical outcomes in eyes with relative anterior microphthalmos (RAM) and shallow anterior chamber undergoing cataract surgery.

Prospective observational study comprised 123 consecutive eyes undergoing phacoemulsification. Group I Shallow anterior chamber; n=50 eyes)had anterior chamber depth(ACD)≤2.5 mm. Group II RAM; n = 73 eyes Intraoperative, postoperative corneal clarity, anterior chamber inflammation, central corneal thickness(CCT)endothelial cell density(ECD) were compared. Further anterior segment optical coherence tomography(AS-OCT) imaging was evaluated for mean change in anterior chamber configuration before and after phacoemulsification. Trabecular-iris angle(TIA)500μm from the scleral spur, angle opening distance(AOD)at 500 μm and 750 μm anterior to the scleral spur and trabecular iris surface area (TISA)at 500μm or 750μm from the scleral spur in the nasal and temporal quadrants were measured.

Intraoperatively, Group II was associated with overall surgical difficulty(P<0.001).The plane of phacoemulsification was more anterior plane and closer to corneal endothelium in Group II (P<0.001). Postoperatively at day 1 anterior chamber flare and cells(P<0.001), poor corneal clarity(P= 0.03) and mean CCT(P<0.001) were significantly more in Group II. There was no statistical difference between endothelial cell loss postoperatively at the 3-month follow-up between 2 groups (P=0.480).On AS-OCT there was no significant difference observed in mean change in TIA, AOD1, AOD2 and TISA in the nasal and temporal quadrants from the preoperative period to 1 month postoperatively when compared between 2 groups.

Relative anterior microphthalmos posed more intraoperative surgical difficulties and early postoperative complications. RAM and shallow anterior chamber impacted similar changes in anterior chamber configuration after cataract surgery as measured by AS-OCT.