The Relationship between Anterior Chamber Depth, Axial Length and Intraocular Lens Power among Candidates for Cataract Surgery
Keywords:
Anterior chamber depth; Axial length; Intraocular lens power; Cataract; IranAbstract
Introduction: Basic anatomical parameters in ophthalmology are variable in different countries according to ethnic groups, genetics and some environmental factors. The aim of this study was to determine the relationship between axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOL) in a referral center from eastern Iran among patients who had cataract surgery, in comparison to studies from other regions of the world.
Methods: In a cross-sectional retrospective study from 2011 to 2013, the records of 698 cataract patients referring to Khatam Al Anbia general hospital in Mashhad, Iran were evaluated. We divided patients, based on their AL and ACD, into three separate groups and compared their results. The SPSS software was used for data analysis. The Chi-Square test and the Independent-samples t-test were used to compare qualitative and quantitative data between two groups, respectively. The Kendall and the Pearson product-moment correlation tests were used to assess the relationship between AL and ACD. The linear Regression model was used to obtain a mathematical model to estimate ACD, using AL, age and sex.
Results: Among individuals who had normal AL (between 22-24.5mm), there was a positive correlation between AL and ACD (p<0.001, r=0.17), however, among individuals with short (AL<22mm) or long sightedness (AL>24.5mm), no significant correlation was detected. We also found that older people have shorter AL (p=0.001 and r=-0.287). Men have an average longer AL (23.7±2.4mm vs. 22.9±2.1mm; p<0.001) and deeper ACD compared to women (2.93±0.45mm vs. 2.82±0.42mm, p=0.002).
Conclusion: Our findings were mostly similar to previous literature from other regions of the world and although some anatomical variations may exist regarding ophthalmic anatomy, factors like race and geographical area have little effect on the relationship between ACD, AL and IOL power calculation, furthermore our results support the use of third and fourth generation formulas for IOL power calculation.
References
Hong T, Mitchell P, Fong CS, Rochtchina E, de Loryn T, Wang JJ. Patients' Short-term Satisfaction With
Cataract Surgery and Long-Term Sustainability of Improved Visual-Related Quality of Life Over 3
Postoperative Years. Asia Pac J Ophthalmol (Phila). 2014; 3(2): 83-7. doi:
1097/APO.0b013e3182a0c492. PMID: 26107490.
Parsons C, Jones DS, Gorman SP. The intraocular lens: challenges in the prevention and therapy of
infectious endophthalmitis and posterior capsular opacification. Expert Rev Med Devices. 2005; 2(2): 161- 73. doi: 10.1586/17434440.2.2.161. PMID: 16293053.
Grob SR, Gonzalez-Gonzalez LA, Daly MK. Management of mydriasis and pain in cataract and intraocular
lens surgery: review of current medications and future directions. Clin Ophthalmol. 2014; 8: 1281-9. doi:
2147/OPTH.S47569. PMID: 25061276, PMCID: PMC4086849.
Van Der Mooren MH, Vidal CC, Piers PA. Systems and methods for determining intraocular lens power.
Google Patents. 2014. 5) Hoffer KJ. The effect of axial length on posterior chamber lenses and posterior capsule position. Current
concepts in Ophthal Surg. 1984; 1: 20-2.
Liesegang TJ, Deutsch TA, Grand MG. Basic and Clinical Science Course, 2002-2003: Ophthalmic
pathology and intraocular tumors (Basic & Clinical Science Course). San fransisso: American Academy of
Ophthalmology. 2002.
Hoffer KJ. Clinical results using the Holladay 2 intraocular lens power formula. J Cataract Refract Surg.
; 26(8): 1233-7. doi: 10.1016/S0886-3350(00)00376-X. PMID: 11008054.
Shammas HJ. Intraocular lens power calculations. Slack Incorporated. 2004; 223.
Olsen T. Prediction of the effective postoperative (intraocular lens) anterior chamber depth. J Cataract
Refract Surg. 2006; 32(3): 419-24. doi: 10.1016/j.jcrs.2005.12.139. PMID: 16631049.
Haigis W. The Haigis formula. Intraocular Lens Power Calculations Thorofare, NJ, Slack. 2004; 45.
Chen H, Lin H, Lin Z, Chen J, Chen W. Distribution of axial length, anterior chamber depth, and corneal
curvature in an aged population in South China. BMC Ophthalmol. 2016; 16(1): 47. doi: 10.1186/s12886- 016-0221-5. PMID: 27138378, PMCID: PMC4852406.
Hashemi H, Khabazkhoob M, Miraftab M, Emamian MH, Shariati M, Abdolahinia T, et al. The
distribution of axial length, anterior chamber depth, lens thickness, and vitreous chamber depth in an adult
population of Shahroud, Iran. BMC Ophthalmol. 2012; 12: 50. doi: 10.1186/1471-2415-12-50. PMID:
, PMCID: PMC3500253.
Luis W Lu, Fine IH. Phacoemulsification in difficult and challenging cases: Thieme. 1999; 184.
Jivrajka R, Shammas MC, Boenzi T, Swearingen M, Shammas HJ. Variability of axial length, anterior
chamber depth, and lens thickness in the cataractous eye. J Cataract Refract Surg. 2008; 34(2): 289-94. doi:
1016/j.jcrs.2007.10.015. PMID: 18242456.
Hoffmann PC, Hutz WW. Analysis of biometry and prevalence data for corneal astigmatism in 23, 239
eyes. J Cataract Refract Surg. 2010; 36(9): 1479-85. doi: 10.1016/j.jcrs.2010.02.025. PMID: 20692558.
Hoffer KJ. Biometry of 7,500 Cataractous Eyes. American journal of ophthalmology. 1980; 90(3): 360-8.
doi: 10.1016/S0002-9394(14)74917-7.
Hosny M, Alio JL, Claramonte P, Attia WH, Perez-Santonja JJ. Relationship between anterior chamber
depth, refractive state, corneal diameter, and axial length. J Refract Surg. 2000; 16(3): 336-40. PMID:
Hoffer KJ. The Hoffer Q formula: a comparison of theoretic and regression formulas. Journal of cataract
and refractive surgery. 1993; 19(6): 700-12. doi: 10.1016/S0886-3350(13)80338-0.
Hsu WC, Shen EP, Hsieh YT. Is being female a risk factor for shallow anterior chamber? The associations
between anterior chamber depth and age, sex, and body height. Indian J Ophthalmol. 2014; 62(4): 446-9.
doi: 10.4103/0301-4738.119344. PMID: 24145564, PMCID: PMC4064220.
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