Anterior chamber depth and complications during cataract surgery in eyes with pseudoexfoliation syndrome.
OBJECTIVE
To look for associations of preoperative A-scan ultrasound ocular dimensions with complications during phacoemulsification in eyes with pseudoexfoliation.


METHODS
A total of 174 eyes with pseudoexfoliation of 135 patients undergoing planned cataract surgery were included in a prognostic study based on the review of a clinical database. Preoperatively, A-scan ultrasound examination with measurement of anterior chamber depth, lens thickness, and total axial length was performed. Phacoemulsification with implantation of a posterior chamber intraocular lens was performed by a total of five surgeons. Intraoperative complications (zonular dialysis and/or vitreous loss) were correlated with preoperative findings including ultrasound dimensions. Multivariate logistic regression analysis with a generalized estimating equations method was used for statistical analysis.


RESULTS
Intraoperative complications occurred in 12 eyes (6.9%) of 11 patients. The anterior chamber was significantly shallower in eyes with than in eyes without complications (mean, 2.36 +/- 0.44 mm vs 2.74 +/- 0.52 mm; P =.013). The differences in lens thickness (4.93 +/- 0.55 mm vs 4.72 +/- 0.54 mm; P =.30) and the differences in axial length (22.92 +/- 1.09 mm vs 23.66 +/- 1.36 mm; P =.07) between the two groups did not reach statistical significance. In eyes with pseudoexfoliation, an anterior chamber depth of less than 2.5 mm was associated with a risk of 13.4% for intraoperative complications compared with an overall incidence of intraoperative complications of 6.9% and an incidence of 2.8% for an anterior chamber depth of 2.5 mm or more.


CONCLUSIONS
A small anterior chamber depth may indicate zonular instability in eyes with pseudoexfoliation syndrome and should alert the cataract surgeon to the possibility of intraoperative complications.
Küchle
M
M
Department of Ophthalmology and University Eye Hospital, Erlangen, Germany. michael.kuechle@augen.med.uni-erlangen.de
Viestenz
A
A
Martus
P
P
Händel
A
A
Jünemann
A
A
Naumann
G O
GO
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000000981:diagnostic imaging / Q000473:pathology*; D017889:Exfoliation Syndrome / Q000150:complications*; D005128:Eye Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000473:pathology; D019654:Lens Implantation, Intraocular; D008022:Ligaments / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018918:Phacoemulsification / Q000009:adverse effects*; D012307:Risk Factors; D014463:Ultrasonography; D014822:Vitreous Body / Q000473:pathology