Decrease In Anterior Chamber Depth Research Articles

Changes in ocular dimensions and refraction with accommodation

The purpose of this study was to measure the changes in ocular dimensions with accommodation, with particular reference to the radius of curvature of the posterior surface of the crystalline lens. The increase in power of the eye with accommodation is considered to arise primarily from a decrease in the radius of curvature of the anterior surface of the lens, with the role of the posterior surface somewhat unclear. We measured the axial dimensions (A-Scan ultrasonography), corneal radius of curvature (keratometry), refractive error (auto-refractor) and radii of curvature of the lenticular surfaces (video phakometry) for 11 subjects, mean age 21.2 +/- 2.6 years, for five levels of ocular accommodation up to 8.00 D. At maximum accommodation the mean changes were a decrease in anterior chamber depth of 0.24 mm, an increase in lens thickness of 0.28 mm, a decrease in radius of curvature of the anterior surface of the lens of 4.95 mm and 1.34 mm for the posterior surface. The corresponding increase in power of the lenticular surfaces for an equivalent refractive index of 1.422 for the lens was 5.53 D and 3.10 D for the anterior and posterior surfaces respectively. No significant changes were recorded in axial length or vitreous chamber depth. We conclude that when crystalline lens power is calculated on the basis of an equivalent refractive index, changes in the posterior surface of the lens contribute around one third of the increase in lens power associated with 8.00 D of ocular accommodation.

Accommodation and Iridotomy in the Pigment Dispersion Syndrome

Iris concavity has been noted in pigment dispersion syndrome, and could have a role in producing iris-zonule contact. Iris concavity is most likely caused by a relative increase in anterior chamber pressure. The method by which this occurs remains speculative. The authors used ultrasound biomicroscopy to examine the role of accommodation in producing iris concavity and to document changes that occur following iridotomy. Thirteen patients with clinically diagnosed pigmentary dispersion and pigmentary glaucoma underwent accommodation studies while being continuously imaged with ultrasound biomicroscopy. Anterior chamber depths were measured and iris configuration noted on distance and near fixation. These studies were repeated in 6 patients following laser iridotomy. All patients showed a decrease in anterior chamber depth with accommodation. Ten patients had a planar iris configuration on distance fixation and 3 concave. Eleven of 13 patients showed increased concavity of the iris on near fixation as compared with distance fixation. Following iridotomy in 6 patients, the iris showed a planar configuration that remained unchanged on near fixation. Accommodation increases iris concavity in some patients with pigment dispersion syndrome. The most likely explanation is an accommodation-induced relative increase in anterior chamber pressure secondary to anterior movement of the lens surface. Iridotomy prevents change in the iris profile with accommodation.

A Releasable Scleral-Flap Tamponade Suture for Guarded Filtration Surgery

Postoperative complications of filtering surgery are generally associated with overfiltration. We describe a technique that employs an externalized releasable suture in partial-thickness filtering surgery. This suture acts as a tamponade on the anterior surface of the scleral flap, assisting in maintenance of anterior-chamber depth during the early postoperative period. After using this technique, anterior-chamber depths preoperatively and 1 day after surgery were compared in 35 phakic patients. A mean (+/- SD) decrease in anterior chamber depth of 4.6% +/- 12% was found on the first postoperative day. One patient had iridocorneal apposition. The mean intraocular pressure 1 day after surgery was 7.0 +/- 7.0 mm Hg, with one patent having an intraocular pressure of 28 mm Hg. This "tamponade suture" appears to be useful in maintaining the anterior chamber depth in the early postoperative period while permitting satisfactory filtration.

Reduction in Axial Length with Age

Mechanisms accounting for the fact that the eye tends to become and remain emmetropic have been proposed for the developing eye, but no such mechanisms have been proposed for the adult eye. In the study reported here, refractive component data published by Sorsby and his co-workers were reanalyzed in terms of the variations in these components with age. Included in the analysis are component data for one eye of each of 271 subjects from age 4 to age 70 years, whose ocular refraction was between plano and +2.00 D. The results of this analysis show that the axial length of the eye appears to decrease during the adult years of life, concurrently with a decrease in anterior chamber depth and an increase in the refractive power of both the cornea and the lens. It is proposed that a reduction in the axial length of the adult eye serves as an emmetropizing mechanism, occurring in harmony with the increase in the refracting power of the eye, which would otherwise cause the refraction of the eye to move in the myopic direction.

Acute shallowing of the anterior chamber.

In aging eyes phenylephrine drops have no significant effect on the depth of the anterior chamber, whereas pilocarpine drops produce a significant shallowing. If both drugs are instilled simultaneously, a significantly greater decrease in anterior chamber depth occurs. The effect is seen in normal, glaucomatous, and hypertensive eyes, and in eyes with shallow anterior chambers. It did not occur in eyes that had had an iridectomy. During the course of a positive provocative test an acute reduction in anterior depth occurs which is reversed when the angle opens and pressure returns to normal levels. It is concluded that the depth of the anterior chamber is not a static dimension but that changes can occur which are rapid and transient. The mechanism of shallowing and deepening depends on an increase or a decrease in the pupil block force. It is a necessary consequence too that eyes with nonshallow anterior chambers can get closed-angle glaucoma and that this possibility cannot be detected by a conventional gonioscopic approach.

Presbyopia and its anatomical and physiological variants

To study the various ocular anatomical and physiological parameters in presbyopia. We studied the various ocular anatomical and physiological parameters like corneal curvature (keratometry readings: K1 and K2), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and axial length (AL) in 100 presbyopic patients between 35 - 55 years of age. The patients were divided into two age groups: I (35 ± 44 years) and II (45-55 yrs). ACD, AL and LT were measured using an Ascan. CCT was measured with ultrasonic pachymetry. The CCT decreased (BE), LT increased and ACD decreased (RE) significantly with increasing age (p less than 0.05). There was no significant difference in males and females. Nearly 3/4th of the total increase in lens thickness was responsible for the decrease in the anterior chamber depth and the rest, 1/4th , goes posteriorly. Corneal curvature and AL showed no significant change with age. The mean of CCT decreased significantly with advancing age. As age increased, the mean value of lens thickness increased and anterior chamber depth decreased. Nearly 3/4th of total increase in LT was anteriorly, decreasing the ACD. Corneal curvature and AL has no relation with age.