Angle widening and alteration of ciliary process configuration after cataract surgery for primary angle closure.
OBJECTIVE
To evaluate quantitatively, by means of ultrasound biomicroscopy (UBM), changes in the anterior segment configuration, including the ciliary processes, induced by cataract surgery in eyes with primary angle closure.


METHODS
Retrospective interventional case series.


METHODS
Thirty-one eyes of 31 patients with primary angle closure or primary angle-closure glaucoma were treated with cataract surgery. Before cataract surgery, 10 eyes had been treated with laser peripheral iridotomy, and 1 with laser peripheral iridoplasty.


METHODS
Configuration of the anterior chamber was examined by means of UBM before and at 3 months after cataract surgery.


METHODS
Using UBM, anterior chamber depth (ACD), angle opening distance at points 500 mum from the scleral spur (AOD500), and trabecular-ciliary process distance (TCPD) were measured.


RESULTS
Not only ACD and AOD500, but also TCPD, increased significantly after cataract surgery, compared with measurements obtained before surgery (P<0.001). Postoperative AOD500 was correlated significantly with postoperative TCPD (r = 0.72, P<0.001) and with the amount of change of TCPD caused by cataract surgery (Delta TCPD) (r = 0.52, P<0.01).


CONCLUSIONS
Cataract surgery attenuated anterior positioning of the ciliary processes in eyes with primary angle closure, concomitant with significant widening of the angle. Cataract surgery resulted in not only complete dissolution of lens volume and pupillary block, but also attenuation of the anterior positioning of the ciliary processes, all of which contributed to postoperative widening of the angle in eyes with primary angle closure.
Nonaka
Atsushi
A
Department of Ophthalmology, Kobe City General Hospital, Kobe, Japan. a-nonaka@pb3.so-net.ne.jp
Kondo
Takehisa
T
Kikuchi
Masashi
M
Yamashiro
Kenji
K
Fujihara
Masashi
M
Iwawaki
Takuji
T
Yamamoto
Kaoruko
K
Kurimoto
Yasuo
Y
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging; D002386:Cataract / Q000150:complications; D002387:Cataract Extraction; D002924:Ciliary Body / Q000000981:diagnostic imaging*; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies