Evaluation of the Changes in Anterior Segment Morphology with Ultrasound Biomicroscopy after Vitrectomy without Use of Tamponade in Pseudophakic Eyes

Aim: In this study we investigated the changes in anterior segment morphology in pseudophakia patients that underwent ultrasound biomicroscopy (UBM) after pars plana vitrectomy (PPV) operation without use of tamponade. Method: Pseudophakic patients who undergo PPV were enrolled in this prospective study between October 2012 and April 2015. Study included patients in whom intraocular tamponade was not used during PPV operation. UBM measurements were performed both before and 10 days after the operation. Anterior chamber depth (ACD) was measured using axial images of anterior segment. Trabecular meshwork-iris angle (TIA), ciliary body thickness (CBT), sclera thickness (ST), trabecular meshwork-ciliary process distance (T-CPD), iris-ciliary processes distance (I-CPD), and iris thickness (IT) were measured at temporal quadrant based on radial section images of the angle. Values measured before and after the operation were statistically compared with each other. Results: This study included 30 patients (18 females, 12 males) that underwent an operation ultrasound biomicroscopy (UBM) after pars plana vitrectomy (PPV) operation without use of tamponade. Mean age was 69.6 ± 9.1 (55 - 85) years. Eighteen operations occurred on the left eye whereas twelve operations occurred on the right eye. CBT1, CBT2, CBT Max, T-CPD, and I-CPD were significantly decreased after operation when compared with the values of baseline (before) (p = 0.018, p = 0.012, p = 0.001, p = 0.033, p = 0.015, respectively). Other evaluated parameters did not show statistically significant changes after the operation (p > 0.05). Discussion: PPV results in significant changes in ciliary body morphology together with changes in anterior segment parameters in pseudophakic cases.

Selective laser trabeculoplasty in pseudophakic and phakic eyes:a prospective study

AIM：To compare the efficacy of selective laser trabeculoplasty（SLT） in replacing medical therapy in pseudophakic and phakic eyes.METHODS：Subgroup of a prospective randomized clinical trial including patients with primary open angle glaucoma or ocular hypertension controlled with medication.Of 38 pseudophakic eyes were matched with 38 phakic eyes.SLT was offered as a way to decrease medication while maintaining the same low eye pressure.SLT was performed over 360°,at 3ns,spotsize 400 μm,100 spots.Data [intraocular pressure（IOP）,number of medications needed] were measured at 1h,1wk,1,3,6 and 12 mo.An independent-samples t-test was performed to compare baseline characteristics of the phakic and the pseudophakic group and differences in evolution of mean IOP and number of used medications.Chi-squared analysis was performed to investigate proportions of fast,slow and non-responders.RESULTS：The mean IOP measurement was 13.00± 2.88 mm Hg in the phakic group（38 eyes） and 13.51±3.06 mm Hg in the pseudophakic group（38 eyes）（P〉0.05）.This changed little after SLT and IOP lowering effect was comparable between the two groups.Main aim however was to lower the amount of medication needed.In the phakic group medication lowered from 1.29±0.62 at baseline,to 0.15±0.46 after 12mo;a reduction of 88.37%.In the pseudophakic group,used medication changed from 1.71±1.04,to 0.41±0.61;a 76.02% reduction.The differences were not statistically significant at any time point（P〉0.05）.IOP lowering occurred slightly faster in thepseudophakic group（50% of patients after one week） than in the phakic group（68% of patients after more than 4wk）.The difference was not significant（P〉0.05）.CONCLUSION：IOP lowering effect of SLT is comparable between phakic and pseudophakic eyes.