Medical hypothesis discovery and innovation in ophthalmology

Abstract

Background: In non-glaucomatous eyes, many factors impact intraocular pressure (IOP) reduction following phacoemulsification. This study aimed to determine the relationship between changes in IOP and alterations in anterior chamber biometric measurements using the Pentacam Scheimpflug anterior segment imaging system before and after uneventful phacoemulsification in non-glaucomatous eyes.
Methods: This prospective interventional study included patients with ages of 20 – 80 years, no known systemic diseases, and visually significant cataracts necessitating phacoemulsification with posterior chamber intraocular lens implantation. The preoperative and two-month postoperative IOPs were measured using a Goldmann applanation tonometer, and the iridocorneal angle (ICA) in four quadrants (superior, inferior, nasal, and temporal), anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured using the Pentacam.
Results: Forty-two eyes of 42 patients with a mean (standard deviation [SD]) age of 56.8 (10.7) years were included; 22 (52%) were men and 20 (48%) were women. The eyes demonstrated statistically significant changes in postoperative IOP, ACD, ACV, and in widening of the ICA (all P < 0.05), with a mean (SD) IOP reduction of 4.5 (2.7) mmHg, ACD deepening of 0.7 (0.6) mm, ACV increase of 33.2 (21.1) mm3, and ICA widening of 7.5o (6.4o), 12.4o (7.7o), 9.1o (7.1o), and 11.5o (6.1o) in the superior, inferior, temporal, and nasal quadrants, respectively. A significant positive correlation was detected between pre- and postoperative IOP (r = + 0.58; P < 0.001) and between pre- and postoperative ACD (r = + 0.50; P < 0.001). Significant negative correlations were detected between preoperative ACV and changes in ACV (r = - 0.42; P < 0.001) and between preoperative ICA and changes in ICA (r = - 0.02; P = 0.001). However, no significant correlations were observed between the changes in IOP and patient age (r = + 0.001; P = 0.957) and axial length of the eye (r = + 0.13; P = 0.221), or changes in ICA (r = - 0.01; P = 0.945), ACD (r = + 0.01; P = 0.945), and ACV (r = - 0.12; P = 0.599).
Conclusions: We observed a significant reduction in IOP, widening of the ICA, and increases in ACD and ACV after phacoemulsification; however, there was no significant correlation between changes in IOP and other biometric variables. Further studies are required to determine the exact mechanisms underlying these effects.