The AC OCT is a user-friendly instrument for evaluating the anterior segment and examining the AC (cornea, iris, crystalline lens, and iridocorneal angle). The 1,310 nm light wavelength is blocked by pigments, preventing examination behind the iris. However, the AC OCT is capable of good image quality and visualization of the anatomical relationships in the anterior segment, even behind an opaque cornea.

Anterior segment optical coherence tomography is a new method to explore the anterior chamber. The target can be focused and defocused with positive or negative lenses to reproduce the conditions of natural accommodation. We studied accommodation in an albino patient because the absence of pigment allows the infrared beam to penetrate the iris and explore the modifications of the ciliary body and the crystalline lens during natural accommodation in a human subject.

Three phakic intraocular lens (IOL) models were implanted in 3 different patients. With the usual slitlamp examination, it was not possible to determine whether there was contact between the IOLs and the natural crystalline lens. Using the anterior chamber optical coherence tomography (AC OCT) scanner, direct contact between the natural crystalline lens and the 3 phakic IOLs was revealed. A dynamic study of the contact was performed during accommodation. These observations show that examination of the anterior segment with the AC OCT scanner provides new data about the status of the anterior segment after implantation of phakic IOLs.

Purpose. Application of anterior segment optical coherence (AS-OCT) in pediatric ophthalmology. Methods. Retrospective clinical study case series of 26 eyes of 19 pediatric patients throughout a 21-month period, presenting anterior segment pathologies, were submitted to AS-OCT examination (OCT Visante, 1310 nm, Zeiss), noncontact technique, no sedation requirement. Results. AS-OCT images were obtained from 19 patients (range: 2 months to 12 years). Clinical diagnosis of anterior segment abnormalities included cornea disease (n = 7), congenital anterior segment conditions (n = 10), ocular trauma (n = 1), anterior segment surgeries (n = 2), iridocorneal angle abnormalities (n = 4), intermediate uveitis (n = 2). The most common OCT findings were corneal hyperreflectivity and thickening (n = 15), shallow anterior chamber with iris-lens diaphragm anterior displacement (n = 4), atypical corneal curvature (n = 4), corneal thinning (n = 4), peripheral synechiae with angle closure (n = 3), increased anterior chamber depth (n = 2), and proximal portion of glaucoma drainage tube (n = 2). Conclusion. In the present study, noncontact AS-OCT demonstrated to be a feasible technique to evaluate the anterior segment providing anatomic details and useful to clarify diagnosis in the pediatric population.

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