Morphological features of anterior segment: factors influencing intraocular pressure after cataract surgery in nanophtha
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RESEARCH
Open Access
Morphological features of anterior segment: factors influencing intraocular pressure after cataract surgery in nanophthalmos Qiang Lu1,2,3,4, Wenwen He1,2,3,4, Yi Lu1,2,3,4 and Xiangjia Zhu1,2,3,4*
Abstract Purpose: To investigate the anterior segment in nanophthalmic eyes and their association with intraocular pressure after cataract surgery. Methods: Thirty-two nanophthalmic eyes (axial length [AL] < 18.5 mm) in 18 patients and 35 normal eyes (21 ≤ AL ≤ 24.5 mm) in 35 controls who had undergone uneventful cataract surgery were included. Swept-source optical coherence tomography was used to compare the anterior segment structures between the two groups. The associations between the anterior segment characteristics of nanophthalmic eyes and postoperative intraocular pressure (IOP) were also investigated. Results: The IOP-lowering effect of cataract surgery was remarkably insufficient in nanophthalmic eyes. Peripheral anterior synechiae (PAS) were observed in 56% (18/32) of nanophthalmic eyes, and a characteristic boomerangshaped iris was observed in 28% (9/32). The anterior surface of the iris seemed “smoother” in nanophthalmic eyes than in normal eyes. Schlemm’s canal (SC) diameter, SC area, trabecular meshwork (TM) thickness, TM width, and TM area were generally smaller in the nanophthalmic eyes. Younger age, higher preoperative IOP, broader PAS, and smaller SC area were main contributors to higher postoperative IOP. AL and SC diameter may also be of great importance in IOP prediction in patients without glaucoma surgery and PAS. Conclusions: The morphological features of the anterior segment in nanophthalmic eyes are significantly different from those of normal eyes. Influencing factors such as age, AL, preoperative IOP, extent of PAS, SC and TM size could all be prognostic for IOP after cataract surgery in nanophthalmic eyes. Trial registration: ClinicalTrails.gov, Trial registration number: NCT02182921, Registered 8 July 2014. Keywords: Nanophthalmos, Anterior segment, Intraocular pressure, Cataract surgery, Peripheral anterior synechiae, Boomerang-shaped iris, Iris crypt, Schlemm’s canal, Trabecular meshwork
* Correspondence: [email protected] 1 Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai 200031, People’s Republic of China 2 Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai 200031, People’s Republic of China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicat
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