Ultrasound biomicroscopy of the anterior segment after congenital cataract surgery.
OBJECTIVE
To evaluate the structure of the anterior segment after congenital cataract surgery with ultrasound biomicroscopy.


METHODS
Ultrasound biomicroscopy was performed on 28 eyes of 15 patients after congenital cataract surgery (age range, 8-27 years; mean, 13.1 +/- 1.1 years), of which 26 eyes had pars plana lensectomy and two eyes had phacoemulsification and aspiration, and on 21 eyes of 11 phakic control subjects who were healthy (age range, 6-17 years; mean, 11.5 +/- 1.1 years). The angle-opening distance at 500 microm was measured on a line perpendicular to the trabecular meshwork 500 microm from the scleral spur, and the trabecular-iris angle was measured.


RESULTS
Angle-opening distance at 500 microm in the congenital cataract group ranged from 174 to 920 microm (mean, 424 +/- 28 microm), and in the control group it ranged from 260 to 1,119 microm (mean, 643 +/- 57 microm), a difference that was significantly different (P =.0004, Student t test). The trabecular-iris angle in the congenital cataract group ranged from 30.4 to 66.9 degrees (mean, 41.9 +/- 1.6 degrees) and in the control group ranged from 32.1 to 69.8 degrees (mean, 44.9 +/- 2.5 degrees), a difference that was not significantly different (P =.28, Student t test). This means that there is a tendency for high insertion of the iris in the congenital cataract group, and intraocular pressure was elevated after surgery (including glaucoma and ocular hypertension) in 10 (47.6%) of 21 eyes with high insertion. The pars plicata after congenital cataract surgery was significantly flatter than that of control subjects (P =.0057, Student t test).


CONCLUSIONS
Ultrasound biomicroscopy is a useful method for evaluating the anterior segment of eyes with congenital cataract, and complications after cataract surgery can be caused by disorganization of the anterior segment. Patients with abnormalities of the anterior segment should be followed up closely for the development of glaucoma.
Nishijima
K
K
Department of Ophthalmology, Tenri Yorozu Hospital, (all authors), Nara, Japan. nissi@kuhp.kyoto-u.ac.jp
Takahashi
K
K
Yamakawa
R
R
D000293:Adolescent; D000328:Adult; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging*; D002386:Cataract / Q000151:congenital*; D002387:Cataract Extraction; D002648:Child; D015785:Eye Diseases, Hereditary / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D014463:Ultrasonography; D014792:Visual Acuity