Factors Associated With Zonular Instability During Cataract Surgery in Eyes With Acute Angle Closure Attack

Kwon, Junki; Sung, Kyung Rim

doi:10.1016/j.ajo.2017.09.003

Cited by 28 publications

(42 citation statements)

References 20 publications

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“…Our results showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than those in the fellow eyes (2.39 mm, P < 0.05) or eyes in the non-AAC group (affected eye 3.24 mm vs fellow eye 3.81 mm). Previously studies of eyes with AAC secondary to lens subluxation found that the ACD of the affected eyes was significantly shallower than that of their fellow eyes (1.34 mm vs. 2.27 mm, and 1.29 mm vs. 2.12 mm), consistent with the results in our present study [1,12]. The central ACD of affected eyes in the non-AAC group was slight shallow, but there is no statistical difference compared with the fellow eyes (P > 0.05).…”

Section: Discussionsupporting

confidence: 93%

“…Lens subluxation can result in a decrease in the depth of the anterior chamber due to the forward movement of the dislocated lens, but not all the patients with lens subluxation have the obvious signs above mentioned. For the eyes with AAC attack caused by lens subluxation, it is difficult to determine the zonular stability before surgery and these signs may be neglected in the clinical setting [1]. A subluxated lens due to zonular weakness or partial loss may lead to pupillary block and sudden closure of the chamber angle [1].…”

Section: Introductionmentioning

confidence: 99%

“…For the eyes with AAC attack caused by lens subluxation, it is difficult to determine the zonular stability before surgery and these signs may be neglected in the clinical setting [1]. A subluxated lens due to zonular weakness or partial loss may lead to pupillary block and sudden closure of the chamber angle [1]. It manifests with severe ocular pain, headache, elevated IOP, and shallow anterior chamber, which are similar to primary AAC.…”

Section: Introductionmentioning

confidence: 99%

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Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

Lin

Qin

et al. 2019

Preprint

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BackgroundTo compare clinical characteristics of lens subluxation between eyes with or without acute angle closure (AAC).MethodsThis is a retrospective and case control study. Thirty-four cases with lens subluxation were recruited from 2015 to 2017. Patients with acute angle closure were assigned to the AAC group (n=17 eyes) and those without AAC were in the non-AAC group (n=17 eyes). Quantitative anterior segment was evaluated by ultrasound biomicroscopy (UBM). Axial length (AL) was measured with IOL master. All patients underwent lens extraction surgery and were followed up for 6 months. ResultsThe history of blunt trauma was accounted for 11 (64.7%) cases in the AAC group and 14 (82.3%) cases in the non-AAC group. Nine (52.9%) patients in the AAC group had LPI or SPI treatment history, and high intraocular pressure was recurred. The UBM analysis showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than the fellow eyes (2.39 mm, P < 0.05) or both eyes in the non-AAC group (affected eye 3.24mm vs fellow eye 3.81mm). Lens vault and AOD500 also showed a remarkable difference between affected eye than fellow eye (P < 0.001) in the AAC group. The both eyes in the AAC group presented a shorter AL and shallower anterior chamber, comparing with those in the non-AAC group. Besides, the affected eyes in the AAC group presented significantly higher LV. ConclusionsThe crowded anterior chamber structure and shorter AL might be an anatomic basis for the eye with lens subluxation induced AAC. Quantitative evaluation of these ocular structures to identify zonular compromise, increased LV and shorter AL are valuable for the diagnosis of lens subluxation induced AAC.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

Lin

Qin

et al. 2019

Preprint

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“…Calculations indicated thatthere was significant difference between any two groups. Some studies [19] in the literature used lens vault (defined as the perpendicular distance between the anterior lens pole and the horizontal line joining the two scleral spurs) measured using UBM as an indicator of lens morphologyand found that lens vault increases in patients with unstable suspensory ligaments of the lens. When the lens is subluxated, the lens zonule dehisencehas a large effect on the position of the lens.…”

Section: Discussionmentioning

confidence: 99%

Biometric indicators of eyes with occult lens subluxation inducing secondary acute angle closure

et al. 2020

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Background: To compare the anterior biometrics in eyes with secondary acute angle closure induced by occult lens subluxation (ASAC-LS), misdiagnosed as acute primary angle closure (APAC) at the first visit with APAC, chronic primary angle closure glaucoma (CPACG), and cataract. Methods: This retrospective case study included 17 eyes with angel closure due to occult LS, who were misdiagnosed as APAC on their first visit, 56 APAC eyes, 54 CPACG eyes, and 56 cataract eyes. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of ocular biometrics. Results: The ASAC-LS patients had a longer ocular axial length than APAC and CPACG patients. Central corneal thickness of the ASAC-LS patients was not significantly different from APAC patients, but was significantly different from CPACG and cataract patients. The APAC patients had the smallest ACD, while the ASAC-LS patients had the smallest AD. The ASAC-LS patients had the largest lens thickness. According to ROC curve analysis, RLP, ACD, AD, CLP, LP had high power of discrimination. Conclusions: This study revealed that LS secondary PAC patients had a shallower AD, thicker CCT comparing to those of APAC, CPACG and cataract patients. For patients with acute angle-closure glaucoma, it is necessary to exclude lens zonula relaxation. Trial registration: NCT03752710, retrospectively registered.

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“…Calculations indicated that there was significant difference between any two groups. Some studies [19] in the literature used lens vault (defined as the perpendicular distance between the anterior lens pole and the horizontal line joining the two scleral spurs) measured using UBM as an indicator of lens morphology and found that lens vault increases in patients with unstable suspensory ligaments of the lens.…”

Section: Discussionmentioning

confidence: 99%

Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

Xing

Huang

Tian

et al. 2019

Preprint

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Background : To compare the anterior biometry of eyes with secondary acute angle closure induced by occult lens subluxation (LS), misdiagnosed as acute primary angle closure (APAC) (ASAC-LS ) at the first visit, APAC, chronic primary angle closure glaucoma (CPACG), cataract. Methods : This retrospective case study included 17 eyes with primary angel closure(PAC)due to occult LS, who were misdiagnosed as APAC on their first visit, 56 eyes diagnosed as APAC, 54 eyes diagnosed as CPACG, and 56 eyes diagnosed as cataract. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD) , aqueous depth (AD) and lens thickness (LT) were recorded. Lens position (LP), relative lens position (RLP), corrected lens position (CLP) were calculated. Quantitative data were subject to one-way analysis of variance and correlation analysis. Categorical data were analyzed using the chi-squared test. Receiver operating characteristic (ROC) curves were plotted to obtain a suitable cutoff value of ocular biometry. Results: The patients in the ASAC-LS group had a longer ocular axial length than those with acute angle closure and CPACG. Corneal thickness in the ASAC-LS group was not significantly different from that in the APAC group, but was significantly different from those of the CPACG and cataract group. The APAC group had the smallest ACD, while the ASAC-LS group had the smallest AD. The ASAC-LS group exhibited significantly shallower AD (P<0.01). The ASAC-LS group had the largest lens thickness. According to ROC curve analysis,RLP, ACD, AD, LP, CLP, CCT were high power of discrimination. Conclusions: This study revealed that LS secondary PAC patients had a shallower AD, thicker CCT comparing to those of APAC, CPACG and cataract patients.LP and CLP can be helpful for differential diagnosis.

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Factors Associated With Zonular Instability During Cataract Surgery in Eyes With Acute Angle Closure Attack

Cited by 28 publications

References 20 publications

Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

Biometric indicators of eyes with occult lens subluxation inducing secondary acute angle closure

Biometric indicators of Eyes with Occult Lens Subluxation inducing Secondary Acute Angle Closure

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