Iridocorneal angle evaluation using hand-held anterior segment optical coherence tomography in cases of congenital cataract

Aim The aim of this study was to describe the anterior chamber angle in congenital cataract cases by using a hand-held anterior segment optical coherence tomography (HH-ASOCT) and to compare it to normal age-matched controls. Patients and methods This prospective study included infants under 2 years of age with congenital cataract (54 eyes of 32 patients) who were compared to normal age-matched control group (44 eyes of 44 patients). Detailed history taking and complete ophthalmological examination were performed, followed by HH-ASOCT imaging and intraoperative intraocular pressure measurement before cataract surgery. Results At the time of surgery, the mean age of the congenital cataract cases was 4.3±2.3 months compared to 5.2±2.1 months in the control cases ( P =0.53). The central corneal thickness was higher in the congenital cataract group (572.7±71.9 µm) compared to the control group (536±36.4 µm), with a statistically significant difference ( P =0.005). In addition, the angle width was significantly wider in the congenital cataract group compared to the control group ( P <0.001). There was no statistically significant difference in the intraocular pressure between the two groups ( P =0.708). The nasal and temporal iris thickness were significantly less in the congenital cataract group than in the control group ( P <0.05). In the normal eyes, the nasal and temporal iris insertion were low in all cases while in the congenital cataract eyes, it was low in 40.8% and mid in 59.2% of the cases, with a statistically significant difference ( P <0.00001). An abnormal angle membrane was found in 25 (46.3%) eyes of the congenital cataract group. Conclusion HH-ASOCT was a useful noninvasive, noncontact, inoffice tool for demonstrating the anterior chamber angle morphological features and abnormalities in congenital cataract patients, which may help in detecting those at risk of glaucoma following cataract surgery.