Anterior segment variations with age and accommodation demonstrated by slit-lamp-adapted optical coherence tomography.
OBJECTIVE
To investigate anterior segment variations with age and accommodation by slit-lamp-adapted optical coherence tomography (SL-OCT) and determine a safe central vault distance between the implantable contact lens (ICL) and the crystalline lens to avoid contact cataract formation.


METHODS
Evaluation of diagnostic test or technology.


METHODS
Eighty-six patients (126 eyes) under regular review from the Optometry Clinic and Outpatient Department in Zhongshan Ophthalmic Center.


METHODS
Patients underwent anterior segment measurements, such as anterior chamber depth (ACD), anterior chamber width (ACW), crystalline lens rise (CLR), and pupil diameter (PD), with the SL-OCT system manufactured by Heidelberg Engineering GmbH, Heidelberg, Germany. Data were analyzed with SPSS software (version 16.0, SPSS, Inc., Chicago, IL).


METHODS
Anterior segment parameters and their variations with age and accommodation.


RESULTS
The internal vertical ACW (V-ACW) was anatomically larger than the internal horizontal ACW (H-ACW). With age, the ACD decreased approximately 17 μm per year. Forward movement of the crystalline lens' anterior pole decreased approximately 11 μm per year. During physiologic accommodation, the variation in ACD was -24 μm per diopter and the alterations in CLR were 28 μm per diopter. According to our data, a safe lens vault after phakic intraocular lens implantation should be more than 300 μm to reduce complications.


CONCLUSIONS
Slit-lamp-adapted optical coherence tomography is a user-friendly instrument for evaluating the anterior segment, especially for accurate anterior chamber biometry, and may offer guidance on minimizing touch and cataract formation after phakic intraocular lens implantation.
Yan
Pi-Song
PS
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Lin
Hao-Tian
HT
Wang
Qi-Lin
QL
Zhang
Zhen-Pin
ZP
D000065:Accommodation, Ocular / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology*; D000869:Anterior Eye Segment / Q000033:anatomy & histology*; D001699:Biometry; D002386:Cataract / Q000517:prevention & control; D002648:Child; D058453:Emmetropia / Q000502:physiology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology; D054120:Phakic Intraocular Lenses; D041623:Tomography, Optical Coherence; D055815:Young Adult