Incidence and Risk Factors for Berger's Space Development after Uneventful Cataract Surgery: Evidence from Swept-Source Optical Coherence Tomography.

Background: This study investigates the incidence and risk factors for the development of Berger’s space (BS) after uneventful phacoemulsification based on swept-source optical coherence tomography (SS-OCT). Methods: Cataractous eyes captured using qualified SS-OCT images before and after uneventful phacoemulsification cataract surgery were included. Six high-resolution cross-sectional anterior segment SS-OCT images at 30° intervals were used for BS data measurements. BS width was measured at three points on each scanned meridian line: the central point line aligned with the cornea vertex and two point lines at the pupil’s margins. Results: A total of 223 eyes that underwent uneventful cataract surgery were evaluated. Preoperatively, only two eyes (2/223, 0.9%) were observed to have consistent BS in all six scanning directions. BS was observed postoperatively in 44 eyes (44/223, 19.7%). A total of 13 eyes (13/223, 5.8%) with insufficient image quality, pupil dilation, or lack of preoperative image data were excluded from the study. A total of 31 postoperative eyes with BS and 31 matched eyes without BS were included in the final data analysis. The smallest postoperative BS width was in the upper quadrant of the vertical meridian line (90°), with a mean value of 280 μm. The largest BS width was observed in the opposite area of the main clear corneal incision, with a mean value >500 μm. Conclusions: Uneven-width BS is observable after uneventful phacoemulsification. Locations with a much wider BS (indirect manifestation of Wieger zonular detachment) are predominantly located in the opposite direction to the main corneal incisions.