Dawood Yousif Farhan, Issa Ammar Fouad, Mohammed Ali Sarmad Salah
Department of Ophthalmology, College of Medicine, University of Anbar, Anbar, Iraq.
Department of Ophthalmology, Ibn Al Haitham Teaching Eye Hospital, Baghdad, Iraq.
Med Hypothesis Discov Innov Ophthalmol. 2023 May 31;12(1):28-35. doi: 10.51329/mehdiophthal1467. eCollection 2023 Spring.
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.
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.
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 < 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) mm, and ICA widening of 7.5 (6.4), 12.4 (7.7), 9.1 (7.1), and 11.5 (6.1) in the superior, inferior, temporal, and nasal quadrants, respectively. A significant positive correlation was detected between pre- and postoperative IOP (r = + 0.58; < 0.001) and between pre- and postoperative ACD (r = + 0.50; < 0.001). Significant negative correlations were detected between preoperative ACV and changes in ACV (r = - 0.42; < 0.001) and between preoperative ICA and changes in ICA (r = - 0.02; = 0.001). However, no significant correlations were observed between the changes in IOP and patient age (r = + 0.001; = 0.957) and axial length of the eye (r = + 0.13; = 0.221), or changes in ICA (r = - 0.01; = 0.945), ACD (r = + 0.01; = 0.945), and ACV (r = - 0.12; = 0.599).
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.
在非青光眼眼中，许多因素会影响白内障超声乳化术后的眼压（IOP）降低情况。本研究旨在使用Pentacam Scheimpflug眼前节成像系统，确定非青光眼患者在白内障超声乳化手术前后，眼压变化与前房生物测量参数改变之间的关系。
这项前瞻性干预性研究纳入了年龄在20 - 80岁之间、无已知全身性疾病且患有需要进行白内障超声乳化联合后房型人工晶状体植入术的明显白内障患者。使用Goldmann压平眼压计测量术前和术后两个月的眼压，并使用Pentacam测量四个象限（上方、下方、鼻侧和颞侧）的虹膜角膜角（ICA）、前房深度（ACD）和前房容积（ACV）。
纳入了42例患者的42只眼，平均（标准差[SD]）年龄为56.8（10.7）岁；其中22例（52%）为男性，20例（48%）为女性。术后眼压、ACD、ACV以及ICA增宽均有统计学意义上的显著变化（均P < 0.05），平均（SD）眼压降低4.5（2.7）mmHg，ACD加深0.7（0.6）mm，ACV增加33.2（21.1）mm³，上方、下方、颞侧和鼻侧象限的ICA分别增宽7.5（6.4）、12.4（7.7）、9.1（7.1）和11.5（6.1）。术前和术后眼压之间存在显著正相关（r = +0.58；P < 0.001），术前和术后ACD之间也存在显著正相关（r = +0.50；P < 0.001）。术前ACV与ACV变化之间存在显著负相关（r = -0.42；P < 0.001），术前ICA与ICA变化之间也存在显著负相关（r = -0.02；P = 0.001）。然而，眼压变化与患者年龄（r = +0.001；P = 0.957）、眼轴长度（r = +0.13；P = 0.221）、ICA变化（r = -0.01；P = 0.945）、ACD变化（r = +0.01；P = 0.945）以及ACV变化（r = -0.12；P = 0.599）之间均未观察到显著相关性。
我们观察到白内障超声乳化术后眼压显著降低、ICA增宽以及ACD和ACV增加；然而，眼压变化与其他生物测量变量之间无显著相关性。需要进一步研究以确定这些效应背后的确切机制。
