Comparing Anterior Segment Ocular Coherence Tomography (AS-OCT),
Ultrasound Biomicroscopy (UBM) and Pentacam in Evaluating the Changes of
the Anterior Segment Parameters after Phacoemulsification
Ahmed Ghoneim
1*
, Tamer Wasfy
1
, Yasser Serag
1
, Hazem Elbedewy
1
, Elsayed Nassar
1
, Ahmed Elmaria
1
Saed AM
2
and Tamer Salem
2
1
Department of Ophthalmology, Faculty of Medicine, Tanta University, Egypt
2
Department of Ophthalmology, Faculty of Medicine, Benha University, Egypt
*
Corresponding author: Ahmed Mohamed Ghoneim, Department of Ophthalmology, Faculty of Medicine, Tanta University, Egypt, Tel: +201005454062; E-mail:
ghoneimfjmm@yahoo.com
Received date: April 18, 2017; Accepted date: May 03, 2017; Published date: May 08, 2017
Copyright: ©2017 Ghoneim A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Cataract extraction affects some of the anterior chamber (AC) parameters like AC depth (ACD) and
the width of the AC angle. Different techniques are used to evaluate these effects before and after cataract
extraction.
Purpose: To evaluate the results of Anterior Segment Optical Coherence Tomography (AS-OCT), Ultrasound
Biomicroscopy (UBM) & Pentacam in evaluating the changes of the anterior segment parameters after cataract
extraction.
Methods: Prospective non-randomized study including 40 cataractous eyes. AS-OCT, UBM and Pentacam were
done 1 week before, 1 week and 1 month after phacoemulsification with intraocular lens (IOL) implantation, to
measure ACD, AC angle width, and central corneal thickness (CCT).
Results: ACD depth, AC angle width and CCT increased significantly 1 week and 1 month after surgery than the
preoperative level (p<0.001), with no significant difference between 1 week and 1 month after surgery (p>0.05). No
significant difference between the 3 techniques in most measures either pre- or postoperatively.
Conclusion: ACD, AC angle width and CCT are significantly increased after uneventful phacoemulsification
surgery and Foldable IOL implantation, which have become stabilized after 1 month of surgery with no significant
difference in the measures given by AS-OCT, UBM or Pentacam.
Keywords: Anterior segment OCT; UBM; Pentacam;
Phacoemulsifcation; AC Angle; Corneal thickness
Introduction
Cataract and various lens disorders are well known to cause changes
in the anterior chamber of the eye, especially the angle and afecting
the intraocular pressure. One of these efects is the narrowing of the
angle which may sometimes proceed to angle closure either in acute,
subacute or chronic forms [1,2]. Tis happens because of the
equatorial age-related growth of the lens which makes the suspensory
ligament slackens and the lens moves anteriorly [3].
Phacoemulsifcation for cataract or even lens extraction with IOL
implantation in eyes with narrow angle can reduce the intraocular
pressure (IOP), open the iridocorneal angles and deepen the anterior
chamber [3-10].
In the traditional clinical settings, direct visualization of the
iridocorneal angle can be done by some diagnostic contact lenses; such
as the Goldmann 3-mirror lens. Te evolution of some new
investigations for the anterior segment of the eye like anterior segment
optical coherence tomography (AS-OCT), ultrasound biomicroscopy
and pentacam, makes it possible to objectively evaluate the structures
of anterior segment of the eye, the iridocorneal angle now can be
objectively fully investigated and well-assessed [12,13].
AS-OCT acts through using light of long wavelength (1,310 nm)
which gives images of high resolution for the anterior segment of the
eye in a non-invasive and non-contact way. It is a rapid technique and
provides quantitative analysis of diferent ocular structures. It also has
repeatability and reproducibility because of its low intraobserver and
interobserver variability [14-17].
Te limitation of AS-OCT technique is its limited penetration of the
iris due to the presence of pigmented epithelium. Tis limitation makes
the obtaining of accurate images for structures behind this pigmented
epithelium (ciliary body, lens and zonules) are difcult [15].
Ultrasound biomicroscopy (UBM) can give images of high-
resolution and good quality for anterior segment including
iridocorneal angle and ciliary body which are not visible with ordinary
gonioscopy [14,16,18]. Te major disadvantage of the UBM technique
is that the transducer requires immersion of the eye in a water bath of
saline with the patient in the supine position. Tis makes the
procedure uncomfortable for the patients and needs a skilled examiner,
the Scheimpfug camera (Pentacam), which uses a slit beam and a
camera, is a non-invasive technique and can be repeated easily but it
Ghoneim et al., J Clin Exp Ophthalmol 2017, 8:3
DOI: 10.4172/2155-9570.1000652
Research Article Open Access
J Clin Exp Ophthalmol, an open access journal
ISSN:2155-9570
Volume 8 • Issue 3 • 1000652
Journal of Clinical & Experimental
Ophthalmology
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ISSN: 2155-9570