Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular mes...Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of BSMMU who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10<sup>th</sup> and 30<sup>th</sup> postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10<sup>th</sup> and 30<sup>th</sup> POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.展开更多
AIM: To evaluate dual Scheimpflug analyzer(Galilei) as a screening method for the diagnostic of gonioscopically narrow anterior chamber angles(ACA). METHODS: In 40 eyes of 40 patients with different ACA range, the ACA...AIM: To evaluate dual Scheimpflug analyzer(Galilei) as a screening method for the diagnostic of gonioscopically narrow anterior chamber angles(ACA). METHODS: In 40 eyes of 40 patients with different ACA range, the ACA, anterior chamber volume(ACV) and anterior chamber depth(ACD) were analyzed using the dual Scheimpflug analyzer(Galilei G6 system). Correspondence between these parameters and Shaffer's classification based on gonioscopy were studied. Receiving operator characteristic(ROC) curves and partition analysis were used to determine the efficacy of the Galilei system in screening for narrow angles. Agreement(Kappa statistics), sensitivity, and specificity for each eye, according to Galilei measures, were also assessed. RESULTS: Shaffer's grade(from 0 to 4) were significantly associated with each of the measurements(P<0.001). In screening eyes with narrow angles with the Galilei, the area under the ROC curve was largest(0.90) when ACD was used as the reference, and partition analysis demonstrated that those eyes were most adequately partitioned with an ACD of 2.86 mm with 100% sensitivity and 80% specificity. CONCLUSION: The Galilei is a secure, repeatable and noncontact screening method for narrow angles. However it does not provide sufficient information about the ACA anatomy to be considered a substitute for gonioscopy.展开更多
文摘Background: The burden of cataract and glaucoma has been increasing. Primary angle closure occurs as a result of crowded anterior segment anatomy causing appositional contact between peripheral iris and trabecular meshwork. Lens extraction has been proposed as a method of deepening anterior chamber and managing intraocular pressure. Purpose: To assess changes in anterior chamber depth after phacoemulsification with intraocular lens implantation in narrow angle eyes. Design: Prospective controlled trial (before-after) study. Method: The study was conducted from March 2015 to August 2017 among the patients of department of Ophthalmology of BSMMU who were diagnosed as cataract with narrow angles. Anterior chamber angle grading of 2 or less (Shaffer grading) in 3 or more quadrants was considered narrow angle (NA). The purposive type sampling technique was applied to collect sample from the study population, as per inclusion and exclusion criteria. Complete clinical evaluation including history, physical examination, relevant ocular examinations and systemic examinations were performed. In this prospective study, subjects underwent phacoemulsification with foldable lens implantation. A scan ultrasonography was performed preoperatively and 10<sup>th</sup> and 30<sup>th</sup> postoperative days of surgery. Results: Thirty eyes of 29 patients included in the study, male: female ratio was 1:1, with an overall mean age of 62.03 ± 8.95 years. The mean preoperative central ACD was 2.95 ± 0.35 mm. At 10<sup>th</sup> and 30<sup>th</sup> POD mean central ACD were 3.94 ± 0.32, and 3.92 ± 0.28 mm respectively. Mean of increase in central ACD at final follow-up was 0.96 mm (p Conclusion: Phacoemulsification with posterior chamber in bag lens implantation can deepen the anterior chamber depth in patients with narrow angles. Based on these findings, it is concluded that phacoemulsification with foldable intraocular lens implantation is an effective tool in deepening the anterior chamber.
文摘AIM: To evaluate dual Scheimpflug analyzer(Galilei) as a screening method for the diagnostic of gonioscopically narrow anterior chamber angles(ACA). METHODS: In 40 eyes of 40 patients with different ACA range, the ACA, anterior chamber volume(ACV) and anterior chamber depth(ACD) were analyzed using the dual Scheimpflug analyzer(Galilei G6 system). Correspondence between these parameters and Shaffer's classification based on gonioscopy were studied. Receiving operator characteristic(ROC) curves and partition analysis were used to determine the efficacy of the Galilei system in screening for narrow angles. Agreement(Kappa statistics), sensitivity, and specificity for each eye, according to Galilei measures, were also assessed. RESULTS: Shaffer's grade(from 0 to 4) were significantly associated with each of the measurements(P<0.001). In screening eyes with narrow angles with the Galilei, the area under the ROC curve was largest(0.90) when ACD was used as the reference, and partition analysis demonstrated that those eyes were most adequately partitioned with an ACD of 2.86 mm with 100% sensitivity and 80% specificity. CONCLUSION: The Galilei is a secure, repeatable and noncontact screening method for narrow angles. However it does not provide sufficient information about the ACA anatomy to be considered a substitute for gonioscopy.
