Moritz C Daniel1, Adam M Dubis2, Maria Theodorou3, Ana Quartilho4, Gillian Adams5, John Brookes6, Maria Papadopoulos6, Peng T Khaw7, Annegret H Dahlmann-Noor8. 1. National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, and Moorfields Eye Hospital, London, United Kingdom; Eye Center, Medical Center, University of Freiburg, Freiburg, Germany. 2. National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, and Moorfields Eye Hospital, London, United Kingdom. 3. National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, and Moorfields Eye Hospital, London, United Kingdom; Pediatric Service, Moorfields Eye Hospital, London, United Kingdom. 4. National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, and Moorfields Eye Hospital, London, United Kingdom; Comprehensive Clinical Trials Unit, University College London, London, United Kingdom. 5. Pediatric Service, Moorfields Eye Hospital, London, United Kingdom. 6. Glaucoma Service, Moorfields Eye Hospital, London, United Kingdom. 7. National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, and Moorfields Eye Hospital, London, United Kingdom; Glaucoma Service, Moorfields Eye Hospital, London, United Kingdom. 8. National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, and Moorfields Eye Hospital, London, United Kingdom; Pediatric Service, Moorfields Eye Hospital, London, United Kingdom. Electronic address: annegret.dahlmann-noor@moorfields.nhs.uk.
Abstract
PURPOSE: To compare Schlemm canal (SC) and trabecular meshwork (TM) in children with healthy eyes and those with and without glaucoma after lensectomy. DESIGN: Cross-sectional observational study. PARTICIPANTS: Fifty children 4 to 16 years of age with healthy eyes and 48 children who underwent lensectomy (124 healthy and 72 postlensectomy eyes). METHODS: Anterior segment (AS) OCT (Tomey SS-1000 CASIA; Tomey, Nagoya, Japan) of the nasal iridocorneal angle at 2 levels of accommodative effort (2.5 diopters [D] and 15 D). For each parameter and state of accommodation, a random effects model was fitted to estimate differences between healthy eyes and eyes with history of lensectomy. MAIN OUTCOME MEASURES: Dimensions of SC and TM and conventional AS OCT iridocorneal angle measurements. RESULTS: The horizontal diameter of SC and its cross-sectional area (CSA) are significantly smaller in eyes that have undergone lensectomy versus healthy eyes. Accommodative effort increases SC size in healthy eyes, but not in eyes that have undergone lensectomy. CONCLUSIONS: Lensectomy is associated with a reduction in SC size and a loss of physiologic SC dilatation during accommodative effort, which may reflect a reduction in outflow facility and may contribute to the development of glaucoma after lensectomy.
PURPOSE: To compare Schlemm canal (SC) and trabecular meshwork (TM) in children with healthy eyes and those with and without glaucoma after lensectomy. DESIGN: Cross-sectional observational study. PARTICIPANTS: Fifty children 4 to 16 years of age with healthy eyes and 48 children who underwent lensectomy (124 healthy and 72 postlensectomy eyes). METHODS: Anterior segment (AS) OCT (Tomey SS-1000 CASIA; Tomey, Nagoya, Japan) of the nasal iridocorneal angle at 2 levels of accommodative effort (2.5 diopters [D] and 15 D). For each parameter and state of accommodation, a random effects model was fitted to estimate differences between healthy eyes and eyes with history of lensectomy. MAIN OUTCOME MEASURES: Dimensions of SC and TM and conventional AS OCTiridocorneal angle measurements. RESULTS: The horizontal diameter of SC and its cross-sectional area (CSA) are significantly smaller in eyes that have undergone lensectomy versus healthy eyes. Accommodative effort increases SC size in healthy eyes, but not in eyes that have undergone lensectomy. CONCLUSIONS: Lensectomy is associated with a reduction in SC size and a loss of physiologic SC dilatation during accommodative effort, which may reflect a reduction in outflow facility and may contribute to the development of glaucoma after lensectomy.
Authors: Moritz C Daniel; Adam M Dubis; Becky MacPhee; Patricia Ibanez; Gillian Adams; John Brookes; Maria Papadopoulos; Peng T Khaw; Maria Theodorou; Annegret H Dahlmann-Noor Journal: Invest Ophthalmol Vis Sci Date: 2019-10-01 Impact factor: 4.799