Detection of Anterior Hyaloid Membrane Detachment Using Deep-Range Anterior Segment Optical Coherence Tomography

Abstract

The visibility of anterior hyaloid membrane (AHM) and Berger’s space in phakic eyes was investigated. In 624 eyes of 624 patients, the retrolental space was scanned with the deep-range anterior segment optical coherence tomography (AS-OCT, CASIA2, Tomey). Subgroup analysis was conducted in 223 eyes undergoing cataract surgery. The logistic regression analysis using the backward-elimination method was performed to evaluate the influence of various factors on the visibility of AHM (dependent variable). Explanatory variables included age, gender, axial length, corneal power, corneal cylinder, and the Co III gradings. Intrarater repeatability for AHM visibility was excellent with the prevalence-adjusted bias-adjusted kappa (κ coefficient) of 0.90. AHM was observed in 43 eyes (6.9%). The patients with visible AHM (68.1 ± 8.8 years) were significantly older than those without visible AHM (52.6 ± 25.6 years) (p < 0.001). The logistic regression analysis in the cataract surgery subgroup revealed that axial length (p = 0.030) and corneal power (p = 0.043) were significantly associated with AHM visibility. The mean absolute refractive error from target was significantly larger in eyes with visible AHM (0.670 ± 0.384 D) than with invisible AHM (0.494 ± 0.412 D) (p = 0.037). The postoperative refractive prediction was less accurate in eyes with visible AHM, but no significant tendency existed in terms of myopic or hyperopic shifts.

Examination of the Vitreolenticular Interface in Relation to Uneventful Phacoemulsification over One-Year Postoperative Period

“…In previous studies among the patients underwent phacoemulsification, using AS-OCT, BS was identified in different percentage before surgery. Zang et al found 0.9% [9], Lin et al 3.4% [8], Mori et al 8.1% of cases [10], while in our study AHM was visible in 18.6%. More recently, Lin et al found 2.5% of cases AVD (anterior vitreous detachment) preoperatively using iOCT [12].…”

“…However, the circumstances of the measurements were not the same. Lin's AS-OCT was unspecified [8], Mori et al measured with CASIA2 (Tomey; Nagoya, Japan) deep-range SS-AS-OCT [10]. Zang et al [9], as well as our team used Anterion SS-AS-OCT.…”

“…It is well known that phacoemulsification has a significant impact on BS [6,8,9,10,12,13,14,15]. In certain cases, using iOCT an open BS with some small floating hyperreflective materials is detectable during phacoemulsification [6,8,12,13,14], or a circular rupture of the AHM can occur [12].…”

Vitreous-lens interface changes after cataract surgery using active fluidics and active sentry with high and low infusion pressure settings

“…[14][15][16]19 Santos-Bueso evaluated the presence of the Berger space using AS-OCT in 90 patients, and he found it in 3 patients. 20 Mori et al evaluated the visibility of AHM in the retrolental space of normal human eyes, and AHM was seen in 6.9% of eyes examined with the deep-range AS-OCT. 21 In this study, postoperatively, eyes with Berger space had higher irrigation pressure and suggest that a comprehensive consideration of irrigation pressure and surgical time may better reflect the effects of cataract surgery on the vitreolenticular interface.…”

Examination of the Vitreolenticular Interface in Relation to Uneventful Phacoemulsification over One-Year Postoperative Period

“…It is well known that phacoemulsification has a significant impact on BS [6,[8][9][10][12][13][14][15]. In certain cases, using iOCT an open BS with some small floating hyperreflective materials is detectable during phacoemulsification [6,8,[12][13][14], or a circular rupture of the AHM can occur [12].…”