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Published on: July 24, 2020
Anterior chamber depth measurements in eyes with an accommodating intraocular lens: agreement between partial
Georgia Cleary1, David J Spalton, John Marshall
1Department of Ophthalmology, St. Thomas' Hospital, Kings College, London, United Kingdom.
Purpose:
To determine agreement between partial coherence interferometry (PCI) and anterior segment optical coherence tomography (AS-OCT) measurements of anterior chamber depth (ACD) and axial intraocular lens (IOL) movement in eyes with an accommodating IOL.
Setting:
Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
Methods:
In this prospective pilot study of cataract patients, the central ACD was measured by PCI (ACMaster) and AS-OCT (Visante) 6 months after unilateral OPAL-A accommodating IOL implantation. Measurements were performed with a distance target and 1.00 diopter (D) and 2.00 D accommodative targets and after administration of topical pilocarpine 4%. Agreement between PCI and AS-OCT ACD measurements and IOL movement was calculated.
Results:
Measurements were obtained in 18 patients. There was a consistent and statistically significant bias toward shallower ACD measurements with AS-OCT than with PCI, with the bias most pronounced after pilocarpine (mean 4.117 mm +/- 0.291 [SD] versus 4.054 +/- 0.287 mm; bias 0.063 mm; P<.0001). Limited IOL movement to 1.00 D and 2.00 D accommodative stimuli was detected with both instruments. After pilocarpine, forward IOL movement measurements were statistically significantly greater by AS-OCT than by PCI (mean 0.306 +/- 0.161 mm versus 0.270 +/- 0.155 mm) (P = .017).
Conclusions:
The AS-OCT device showed a bias toward underestimation of ACD compared with the PCI device. The bias increased as ACD shallowed with pilocarpine, resulting in overestimation of forward IOL movement by AS-OCT. This may lead to overestimation of the accommodative performance of IOLs. The ACD measurements obtained by the 2 devices are not interchangeable.
