Fluctuations of Anterior Chamber Depth and Astigmatism in Pseudophakic Eyes

Larysa Tutchenko,1,&ast; Sudi Patel,2,&ast; Mykhailo Skovron,1,&ast; Oleksiy V Voytsekhivskyy,1,&ast; Fanka Gilevska3,&ast; 1Department of Corneal Pathology, Ophthalmic Oncology and Oculoplasty, Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Kyiv, 03680, Ukraine; 2Department of Cataract and Refractive Surgery, University Eye Clinic Svjetlost, Zagreb, 10000, Croatia; 3Department of Refractive Surgery, Eye Clinic Sistina Oftalmologija, Skopje, 1000 Republic of North Macedonia&ast;These authors contributed equally to this workCorrespondence: Sudi Patel, Department of Cataract and Refractive Surgery, University Eye Clinic Svjetlost, Heinzelova 39, Zagreb, 10000, Croatia, Email [email protected]: To explore the significance of changes in anterior chamber depth (ΔACD) and astigmatism between 4 and 8 weeks following uneventful phacoemulsification.Patients and Methods: Anterior chamber depth (ACD, mm), autorefractometry and subjective refraction were monitored in pseudophakic eyes implanted with non-toric IOLs (group 1, SA60AT, n=36; group 2, SN60WF, n=34; group 3, ICBOO, n=16) and phakic control group (n=30, group 4a, for ACD and autorefractometry) over four weeks. Changes in subjective refractions were compared with repeatability in normal phakic eyes (n=30, group 4b).Results: Reporting key results (p< 0.01), mean (±sd 95% CI) ΔACD values (ACD at start minus ACD at four weeks) were +0.02 (± 0.37, − 0.16 to 0.08), +0.22 (± 0.51,0.05 to 0.39), − 0.33 (± 0.51, − 0.58 to − 0.08), − 0.02 (± 0.07, − 0.04 to 0.01) in groups 1– 4a respectively. Differences were significant (1-way ANOVA, F=7.02). Pooling data from the pseudophakic eyes (n=86) induced astigmatism (IA) by autorefractometry was significantly greater in comparison with group 4a [− 0.78D (± 0.67, − 0.92 to − 0.64) and − 0.19D (± 0.16, − 0.25 to - 0.13)]. IA power correlated with the initial power of refractive astigmatism at 4 weeks (A), [IA = 0.36A− 0.30 (r2=0.207) and IA = 0.39A− 0.29 (r2=0.232) by autorefractometry and subjective refraction, respectively]. In groups 1– 3, vector analysis revealed i) the change in refraction in over 55% of eyes was beyond the 95% confidence interval limits observed in groups 4a and 4b, ii) some significant associations between changes in vectors describing astigmatism with ΔACD and IOL labelled power.Conclusion: Changes in ACD and refraction still occur four weeks after unremarkable phacoemulsification and the inter-relationship depends on IOL design/type. Other factors, such as tilt or dislocation of the IOL along the X-Y axes parallel to Listing’s plane, accompanying changes in ACD are expected to affect the postop astigmatism.Keywords: anterior chamber depth (ACD), astigmatism, IOL position, refraction, phacoemulsification