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Accept Date 2019-07-29 ABSTRACT Background: To use the Sirius imaging system to precisely evaluate the changes in the anterior chamber depth and angle before and after phacoemulsification of intumescent cataract in eyes with different axial lengths. Methods: A prospective study that included consecutive patients with intumescent cataract in one eye. All eyes were subjected to full ophthalmic examination, IOP, gonioscopy, ocular ultrasonography (A and B scans), IOL master and axial length measurement. Anterior segment imaging of both eyes using Sirius imaging system to determine the anterior chamber angle (ACD) and anterior chamber angle (ACA). Eyes were classified into three groups according to their axial length (AXL); Group I: axial length < 22 mm, Group II: axial length 22 – 24.5 mm, and Group III: axial length > 24.5 mm. Postoperative examinations were performed at 1 day, 1 week, 1 month and 3 months. Results: The study enrolled 32 eyes; Group I included 11 eyes, Group II included 11 eyes and Group III included 10 eyes. Before surgery, the mean ACD was 2.03 ± 0.46 mm in Group I, 2.2 ± 0.42 mm in Group II and 2.62 ± 0.37 mm in Group III (P < 0.05). The mean ACA width was 18.36 ± 3.64 ° in Group I, 20.27 ± 4.86° in Group II and 26.8 ± 7.93° in Group III (P < 0.05). The mean IOP was 22.73 ± 1.74 mmHg in Group I, 14.45 ± 1.13 mmHg in Group II and 13.7±0.95 mmHg in Group III (P < 0.05). After surgery, all the investigated parameters have been statistically significantly changed when compared to the preoperative values (P < 0.05). The mean ACD was 3.44± 0.28 mm with a mean relative change (80.19 %) in Group I, 3.3 ± 0.39 mm with a mean relative change ( 52.76%) in Group II and 3.33±0.32 mm with a mean relative change ( 30.76%) in Group III (P < 0.05). The mean ACA width was 32.36 ± 3.72 ° with a mean relative change (82.35%)in Group I, 31.64 ± 2.62 ° with a mean relative change (58.82%) in Group II and 32.1±7.22 ° with a mean relative change (20%) in Group III (P < 0.05). The mean IOP was 15.82 ± 1.33 mmHg with a mean relative change ( 30%) in Group I, 12.36± 1.33mmHg with a mean relative change (14.29 %) in Group II and 12 ± 1.25 mmHg with a mean relative change ( 7.69%) in Group III (P < 0.05). Conclusion: Intumescent cataract induces significant reductions in the ACD and ACA and phacomorphic glaucoma could be induced in short eyes. Phacoemulsification significantly increases the ACD and ACA width and could be an effective treatment of phacomorphic glaucoma. Measuring the axial length in eyes with intumescent cataract could predict eyes susceptible to phacomorphic glaucoma.

Changes in Anterior Chamber Depth and Angle Before and After Phacoemulsification of Intumescent Cataract