Anterior chamber depth and complications during cataract surgery in eyes with pseudoexfoliation syndrome

PURPOSE: To look for associations of preoperative A-scan ultrasound ocular dimensions with complications during phacoemulsification in eyes with pseud oexfoliation. METHODS: A total of 174 eyes with pseudoexfoliation of 135 patients undergo ing planned cataract surgery were included in a prognostic study based on. the review of a clinical database. Preoperatively, A-scan ultrasound examin ation with measurement of anterior chamber depth, lens thickness, and total axial length was performed. Phacoemulsification with implantation of a pos terior chamber intraocular lens was performed by a total of five surgeons. Intraoperative complications (zonular dialysis and/or vitreous loss) were c orrelated with preoperative findings including ultrasound dimensions. Multi variate logistic regression analysis with a generalized estimating equation s method was used for statistical analysis. RESULTS: Intraoperative complications occurred in 12 eyes (6.9%) of 11 pati ents. The anterior chamber was significantly shallower in eyes with than in eyes without complications (mean, 2.36 +/- 0.44 mm vs 2.74 +/- 0.52 mm; P = .013). The differences in lens thickness (4.93 +/- 0.55 mm vs 4.72 +/- 0. 54 mm; P = .30) and the differences in axial length (22.92 +/- 1.09 mm vs 2 3.66 +/- 1.36 mm; P = .07) between the two groups did not reach statistical significance. In eyes with pseudoexfoliation, an anterior chamber depth of less than 2.5 mm was associated with a risk of 13.4% for intraoperative co mplications compared with an. overall incidence of intraoperative complicat ions of 6.9% and an incidence of 2.8% for an anterior chamber depth of 2.5 mm or more. CONCLUSIONS: A small anterior chamber depth may indicate zonular instabilit y in eyes with pseudoexfoliation syndrome and should alert the cataract sur geon to the possibility of intraoperative complications. (C) 2000 by Elsevi er Science Inc. All rights reserved.