Appraisement of Anterior Segment Changes caused by Vitrectomy without Internal Tamponade using Ultrasonic Biomicroscopy in Phakic Eyes

Abstract

The first use of ultrasound biomicroscopy (UBM), which is an important method for monitoring and evaluating the anterior segment and the anterior chamber angle in ophthalmology, was made by Pavlin et al. (1) in the early 1990s. Sound energy is used in the high-frequency spectrum in UBM. With this spectrum, tissue penetration occurs to a depth of about 5 mm, which is more or less on the surface. UBM is a tool that enables the identification of not only anterior segment structures but also pathologies located in posterior segment structures such as the peripheral retina and ciliary body. It is an important imaging modality in the treatment of vitreoretinal diseases by cross-sectional imaging of the peripheral retina, pars plana, and vitreous base, which cannot be seen even via indirect ophthalmoscopy performed using a scleral buckling method.The most important advantage of UBM compared with anterior segment optical coherence tomography is that posterior chamber structures such as the ciliary body, lens zonules, and anterior choroid can also be displayed without dilating the pupils (2).In many vitreoretinal diseases, pars plana vitrectomy (PPV) is applied as the standard surgical approach. Many complications related to PPV may be encountered postoperatively. Some of these complications are related to the anterior segment.The aim of this study was to investigate by UBM postoperative changes in the morphology of the anterior segment in phakic patients in whom tamponade was not used during PPV. MethodsBetween March 2012 and October 2015, phakic patients for whom PPV was planned were included in the study prospectively. Patients on whom cataract surgery was performed along with PPV and/or gas or silicone oil was used as intraocular tamponade were excluded from the study, and 21 eyes of 21 patients were statistically included in the evaluation.The study was performed in accordance with the Helsinki Declaration. All patients who were included in the study were given information regarding the intervention and written informed consent was received. Approval of the local ethics committee was obtained for the execution of the work. Appraisement of Anterior Segment Changes caused by Vitrectomy without Internal Tamponade using Ultrasonic Biomicroscopy in Phakic EyesObjective: Our study aimed to investigate morphological changes using ultrasonic biomicroscopy (UBM) in the anterior segment after phakic pars plana vitrectomy (PPV) without tamponade.Methods: PPV surgery planned phakic patients were prospectively studied between October 2012 and March 2015. PPV patients who did not undergo cataract surgery and in whom intraocular tamponade was not used were included in the study. UBM measurements were taken a few days before and 10 days after the surgery. Through axial images of the anterior segment, the anterior chamber depth (ACD) and lens thickness (LT) were measured. Through the temporal quadrant over the radial cross-section images, the trabecular network-iris angle (TIA), ciliary body thickness (CBT), scleral thickness (ST),...

Evaluation of the Changes in Anterior Segment Morphology with Ultrasound Biomicroscopy after Vitrectomy without Use of Tamponade in Pseudophakic Eyes

“…We did another study to evaluate the morphological changes of the anterior segment using UBM imaging in phakic patients who underwent PPV without internal tamponade agent [30]. In this study, patients who underwent PPV without internal tamponade agent injection at the phakic eyes, postoperative mean values of TIA were found to be significantly increased.…”

“…This may be related to the spherical structure of posterior surface of lens inside the eye. At the both of the study, patients who underwent PPV without internal tamponade agent, postoperative mean values of CBT, and T-CPD, according to preoperative values, were found to be significantly reduced [30].…”

Assessment of Anterior Segment Changes in Pseudophakic Eyes, Using Ultrasonic Biomicroscopic Imaging, after Pars Plana Vitrectomy with Silicone Oil or Gas Tamponade

“…In addition our study only includes a small sample size of each disorder, which may have influenced morphological changes of the anterior segment among vitreoretinal disorders. Intraobserver reproducibility is high for all the measurements performed using this technique, but interobserver reproducibility is poor [ 27 ]. Therefore, UBM examinations were performed by the same surgeon.…”