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Fulltext Agreement analysis of Pentacam and Lenstar in measurement of keratometry, anterior chamber depth and lens thickness

Azlindarita A. Mohd Abdullah, Norasyikin Mustafa, Pei LV, Subrayan V

Journal of Clinical and Health Sciences, 2016;1:10-15.

To assess the agreement of the Scheimpflug camera system Pentacam with the optical low-coherence reflectometry (OLCR) device LENSTAR LS900 in measuring anterior segment biometry.

Matched MeSH terms: Anterior Chamber
Fulltext Anterior chamber implantation at University Hospital, Kuala Lumpur

Lim TK

Med J Malaysia, 1984 Sep;39(3):205-9.
PMID: 6544921

50 cases of anterior chamber intraocular lens implantation at the University Hospital, Kuala Lumpur were studied. 80% of the cases achieved visual acuity of 6/9 or better. The percentage would be higher if cases with pre-existing pathology are excluded and the period of follow-up is longer. Complications, mainly minor and non sight-threatening, are discussed.

Matched MeSH terms: Anterior Chamber*
Fulltext Comparison of refractive outcomes in post cataract surgery using measurements from immersion and Contact A-scan biometry techniques

Bariah Mohd-Ali, Nazirin Arsad, Zainora Mohammed

Jurnal Sains Kesihatan Malaysia, 2012;10(1):13-18.
MyJurnal

It is possible that different techniques used to measure axial length (AL) and anterior chamber depth (ACD) is the cause of discrepancy in refractive outcomes of cataract surgery. This study evaluated the agreement and repeatability of AL and ACD measurements using immersion and contact A-scan biometry techniques and compared the refractive outcomes from both techniques. Twenty four patients were evaluated for agreement and repeatability of AL and ACD measurements using the two different methods. The results were analyzed using Bland and Altman plots. Another 60 patients with age-related cataract were selected to compare the refractive outcomes between both methods. The IOL power was calculated using Sanders- Retzlaff- Kraff- Theoretical (SRK-T) equation. Refraction was determined between four to six weeks postoperatively and the results were analyzed using paired t-test. The results of this study showed good agreement between both techniques was noted with no significant difference detected between measurements (p > 0.05). Significant correlation was found in all parameters (AL: r = 0.99; p < 0.01, r = 0.99; p < 0.01) ACD: r = 0.91; p < 0.01, r = 0.97; p < 0.01). No significant difference in refractive outcomes of post cataract surgery was detected between the two techniques (p = 0.07). This study concludes that contact A-scan biometry and immersion techniques provide reliable results and should not be the cause of discrepancy in the refractive planned and outcome of cataract surgery.

Matched MeSH terms: Anterior Chamber
Fulltext Allometry and Scaling of the Intraocular Pressure and Aqueous Humour Flow Rate in Vertebrate Eyes

Zouache MA, Eames I, Samsudin A

PLoS One, 2016;11(3):e0151490.
PMID: 26990431 DOI: 10.1371/journal.pone.0151490

In vertebrates, intraocular pressure (IOP) is required to maintain the eye into a shape allowing it to function as an optical instrument. It is sustained by the balance between the production of aqueous humour by the ciliary body and the resistance to its outflow from the eye. Dysregulation of the IOP is often pathological to vision. High IOP may lead to glaucoma, which is in man the second most prevalent cause of blindness. Here, we examine the importance of the IOP and rate of formation of aqueous humour in the development of vertebrate eyes by performing allometric and scaling analyses of the forces acting on the eye during head movement and the energy demands of the cornea, and testing the predictions of the models against a list of measurements in vertebrates collated through a systematic review. We show that the IOP has a weak dependence on body mass, and that in order to maintain the focal length of the eye, it needs to be an order of magnitude greater than the pressure drop across the eye resulting from gravity or head movement. This constitutes an evolutionary constraint that is common to all vertebrates. In animals with cornea-based optics, this constraint also represents a condition to maintain visual acuity. Estimated IOPs were found to increase with the evolution of terrestrial animals. The rate of formation of aqueous humour was found to be adjusted to the metabolic requirements of the cornea, scaling as Vac(0.67), where Vac is the volume of the anterior chamber. The present work highlights an interdependence between IOP and aqueous flow rate crucial to ocular function that must be considered to understand the evolution of the dioptric apparatus. It should also be taken into consideration in the prevention and treatment of glaucoma.

Matched MeSH terms: Anterior Chamber/physiology
Fulltext ABCC5, a gene that influences the anterior chamber depth, is associated with primary angle closure glaucoma

Nongpiur ME, Khor CC, Jia H, Cornes BK, Chen LJ, Qiao C, et al.

PLoS Genet, 2014 Mar;10(3):e1004089.
PMID: 24603532 DOI: 10.1371/journal.pgen.1004089

Anterior chamber depth (ACD) is a key anatomical risk factor for primary angle closure glaucoma (PACG). We conducted a genome-wide association study (GWAS) on ACD to discover novel genes for PACG on a total of 5,308 population-based individuals of Asian descent. Genome-wide significant association was observed at a sequence variant within ABCC5 (rs1401999; per-allele effect size = -0.045 mm, P = 8.17 × 10(-9)). This locus was associated with an increase in risk of PACG in a separate case-control study of 4,276 PACG cases and 18,801 controls (per-allele OR = 1.13 [95% CI: 1.06-1.22], P = 0.00046). The association was strengthened when a sub-group of controls with open angles were included in the analysis (per-allele OR = 1.30, P = 7.45 × 10(-9); 3,458 cases vs. 3,831 controls). Our findings suggest that the increase in PACG risk could in part be mediated by genetic sequence variants influencing anterior chamber dimensions.

Matched MeSH terms: Anterior Chamber/metabolism; Anterior Chamber/pathology*
Review of Risk Factors and Complications of Anterior Migration of Ozurdex Implant: Lessons Learnt from the Previous Reports

Khor HG, Lott PW, Wan Ab Kadir AJ, Singh S, Iqbal T

J Ocul Pharmacol Ther, 2024;40(6):342-360.
PMID: 37676992 DOI: 10.1089/jop.2023.0012

Purpose: Ozurdex had shown promising anatomical and functional outcomes in managing refractory Irvine-Gass syndrome over the years. Burgeoning usage of Ozurdex has prompted the study of its related complications, particularly the anterior chamber migration of the implant. Methods: Literature reviews on the anterior chamber migration of the Ozurdex via PubMed, EBSCO, and TRIP databases were searched from 2012 to 2020. The predisposing factors, outcomes, and management of such cases were evaluated. Results: A total of 54 articles consisting of 105 cases of anterior migration of Ozurdex were included in this analysis. The vitrectomized eye and compromised posterior capsule were highly associated with this complication. About 81.9% of the cases had cornea edema upon presentation, with 31.4% of them ending up with cornea decompensation despite intervention. Although there was high intraocular pressure reported initially in 22 cases, only 2 cases required glaucoma filtration surgeries in which they had preexisting glaucoma. Numerous techniques of repositioning or surgical removal of the implant were described but they were challenging and the outcomes varied. Conclusions: A noninvasive method of manipulating the Ozurdex into the vitreous cavity via the "Trendelenburg position, external pressure with head positioning" maneuvers is safe yet achieves a favorable outcome. Precaution must be taken whenever offering Ozurdex to the high-risk eyes. Prompt repositioning or removal of the implant is crucial to deter cornea decompensation. Clinical Trial Registration number: NMRR-22-02092-S9X (from the Medical Research and Ethics Committee (MREC), Ministry of Health, Malaysia).

Matched MeSH terms: Anterior Chamber/drug effects; Anterior Chamber/surgery
Fulltext ‘Boating’ out migrated dexamethasone implant; surgical management of removal of anterior chamber migrated dexamethasone intravitreal implant: a case report

Teo, B.H., Safinaz, M.K., Mae-Lynn, C.B., Amin, A., Edward, R., Mushawiahti, M.

Medicine & Health, 2018;13(2):175-179.
MyJurnal

It is rare for anterior chamber migration of an Ozurdex® implant from vitreous cavity, but it is seen more frequently in aphakic eyes or in pseudophakic cases with zonular dehiscense. We describe a case of a middle-aged gentleman who had persistent diabetic macular oedema not responding to anti-VEGF (vascular endothelium growth factor), who was treated with intravitreal Ozurdex® in his post vitrectomized eye and developed anterior migration of the implant to the anterior chamber. Anterior dislocation of an intravitreal implant of dexamethasone can be managed by repositioning it to the vitreous cavity or removing it through a corneal limbal incision. Ozurdex® is a friable implant, especially after a few weeks of implantation. Therefore, removal of the implant by grasping or aspiration may lead to its fracture or dispersion of the implant material. This is a report of a simple,fast and effective technique to remove a migrated Ozurdex® from the anterior chamber using a modified silicone tip.

Matched MeSH terms: Anterior Chamber
Fulltext Bilateral spontaneous rupture of anterior lens capsules in a middle-aged woman

Hemalatha C, Norhafizah H, Shatriah I

Clin Ophthalmol, 2012;6:1955-7.
PMID: 23225999 DOI: 10.2147/OPTH.S37276

Hypermature cataracts are commonly seen in developing countries. Spontaneous rupture of the anterior capsule, resulting in dislocation of the lens nucleus into the anterior chamber, presents rarely in hypermature cataracts. We describe a middle-aged woman who presented with spontaneous anterior dislocation of the nucleus in both eyes. The presence of calcification spots in the posterior capsule at the pupillary edge strongly suggested that our patient had hypermature cataracts. It is important to highlight this uncommon cause of nucleus dislocation in a patient with no previous history of ocular trauma.

Matched MeSH terms: Anterior Chamber
Fulltext Herpes zoster keratouveitis with hypopyon and hyphema

Katherine SBH, Ngim YS, Juliana J, Ramli N

Taiwan J Ophthalmol, 2020 03 04;10(1):54-57.
PMID: 32309125 DOI: 10.4103/tjo.tjo_20_18

This study aims to report two cases with an uncommon, early manifestation of herpes zoster ophthalmicus which is keratouveitis. The first patient is a 61-year-old female who had presented with painful facial skin eruption and right eye redness without impairment of vision. She was treated initially as herpes zoster blepharoconjunctivitis; however, the disease had progressed to neurotrophic keratitis with severe anterior chamber reaction manifested by a mixture of hypopyon and hyphema. The second patient is a 74-year-old female who had presented after 2 weeks of facial skin eruption with blurring of vision and similar keratouveitic manifestations. Both patients had poor visual outcome due to severe ocular inflammation.

Matched MeSH terms: Anterior Chamber
Blurring of vision due to VLM

Kamala D, Rohela M, Khairul Anuar A, Jamaiah I

JUMMEC, 1999;4:115-116.

A thirty two year old taxi driver presented with cotnplaints of headache, nausea, vomiting and blurring of vision of the left eye of two days duration. He was found to have an acute anterior uveities and secondary glaucoma. On further examination patient was also found to have a neuroretinitis and phlebitis in the same eye. A worm was found in the anterior chamber and it was removed via a limbal incision under local anaesthesia. The worm-like structure sent to the Department of Parasitology was identified as Gnathostoma spinigerum. he patient was treated with topical eye drops and oral steroids at the same time to reduce the inflammation. No neurological symptoms were seen. The patient was not available for further evaluation and followup. KEYWORDS: Blurring of vision, Gnathostomiasis

Matched MeSH terms: Anterior Chamber
Effect of haemodialysis on intraocular pressure

Samsudin A, Mimiwati Z, Soong T, Fauzi MS, Zabri K

Eye (Lond), 2010 Jan;24(1):70-3.
PMID: 19229270 DOI: 10.1038/eye.2009.33

To study the effect of haemodialysis on intraocular pressure (IOP) of patients at the University Malaya Medical Centre, Kuala Lumpur, and the influence of anterior chamber angles, surgery, and diabetes on the change in IOP after haemodialysis.

Matched MeSH terms: Anterior Chamber/pathology
Fulltext Bilateral anterior chamber intraocular lenses dislocation in a patient with habitual eye rubbing

Poh EP, Fariza NN, Mariam I

Med J Malaysia, 2005 Aug;60(3):370-2.
PMID: 16379196

A 61-year-old Chinese man presented with bilateral posteriorly dislocated anterior chamber intraocular lenses (AC IOLs) one year after successful vitrectomy, removal of bilateral dislocated mature cataractous lenses and AC IOLs implantation. A thorough clinical evaluation revealed habitual eye rubbing as the only possible cause.

Matched MeSH terms: Anterior Chamber/pathology*
Fulltext Distribution of axial length, anterior chamber depth, and corneal curvature in an aged population in South China

Chen H, Lin H, Lin Z, Chen J, Chen W

BMC Ophthalmol, 2016 May 01;16(1):47.
PMID: 27138378 DOI: 10.1186/s12886-016-0221-5

BACKGROUND: Ocular biometry is important for preoperative assessment in cataract and anterior segment surgery. The purpose of this study was to investigate normative ocular biometric parameters and their associations in an older Chinese population.
METHODS: This was a cross-sectional observational study. From 2013 to 2014, we recruited inhabitants aged 50 years or older in Guangzhou, China. Among 1,117 participants in the study, data from 1,015 phakic right eyes were used for analyses. Ocular parameters including axial length (AL), anterior chamber depth (ACD), and corneal curvature (K) were measured using an IOL Master.
RESULTS: The mean AL, ACD, and K were 23.48 mm [95 % confidence interval (CI), 23.40-23.55], 3.03 mm (CI, 3.01-3.05), and 44.20 mm (CI, 44.11-44.29), respectively. A mean reduction in ACD with age was observed (P = 0.002) in male subjects but not in female subjects (P = 0.558). Male subjects had significantly longer ALs (23.68 mm versus 23.23 mm, P anterior chamber (r = 0.652, p

Matched MeSH terms: Anterior Chamber/anatomy & histology*
Fulltext Ocular biometry in the subtypes of primary angle closure glaucoma in University Malaya Medical Centre

Mimiwati Z, Fathilah J

Med J Malaysia, 2001 Sep;56(3):341-9.
PMID: 11732081

Thirty-seven consecutive patients (41 eyes) diagnosed with primary angle closure glaucoma (PACG) attending the Glaucoma Clinic in University Malaya Medical Centre, over a period of 6 months were categorized into acute, subacute and chronic PACG from their clinical presentation. Each case was subjected to automated refraction, A-scan biometry for anterior chamber depth, axial length and lens thickness, keratometry and corneal diameter measurement. Calculations for the relative lens position and the lens thickness: axial length index were performed. The data collected was analysed by the nonparametric test (Kruskal-Wallis), one way analysis of variance (ANOVA), chi-square test, Spearman's nonparametric correlations and regression analysis. For controls 15 eyes from 15 normal subjects matched for age, sex, refractive error and race were chosen and subjected to the same examinations. Chronic PACG was the predominant subtype (53.6% of patients and 58.5% of eyes). The ocular biometric measurements of acute PACG eyes deviated most from normals in having the shallowest anterior chamber depth, shortest axial length, smallest corneal diameter, steepest corneal radius, thickest and most anteriorly situated lens, and the greatest lens thickness: axial length index. The subacute subtype was closest to normal and chronic PACG subtype fell in between in most of the biometric characteristics. These findings were not statistically significant. All PACG eyes as a group however showed statistically significant shallower anterior chamber depth (p < 0.05), and a more anterior relative lens position (p < 0.05) compared to normals.

Matched MeSH terms: Anterior Chamber/pathology
Fulltext The role of tranexamic acid (Cyklokapron) in the treatment of traumatic hyphaema

Sukumaran K

Med J Malaysia, 1988 Jun;43(2):155-8.
PMID: 3237131
Matched MeSH terms: Anterior Chamber/injuries*
Fulltext A review of intraocular foreign bodies treated at the University Hospital Kuala Lumpur

Teoh GH, Yow CS

Med J Malaysia, 1982 Mar;37(1):7-10.
PMID: 7121351

A retrospective study of intraocular foreign bodies treated at the University Hospital over 10 years from 1970 - 1979 was carried out. Of the 48 cases reviewed, nine were anterior chamber foreign bodies while the rest were posterior segment foreign bodies. The anterior chamber foreign bodies had better visual prognosis as compared to the posterior segment foreign bodies. Most of the patients were young Chinese males and most of the injuries were due to accidents at work involving the 'hand hammer' (includes other implements used as a hammer).

Matched MeSH terms: Anterior Chamber/injuries
Fulltext Case series of ocular tuberculosis; the great masquerader

Loh, Ui Lyn, Nadras, Indira, Yeong, Choo Mee, Nadarajah, Gaayathri, Fazilawati Qamarruddin, Shelina Oli Mohamed, et al.

Journal of Biomedical and Clinical Sciences, 2018;3(2):1-5.
MyJurnal

Tuberculosis, an ancient disease, still thrives today as the leading infection caused by Mycobacterium tuberculosis. Diagnosis of ocular tuberculosis poses a great challenge due to the varied clinical presentations. We report 3 cases of primary ocular tuberculosis with varied presentations: conjunctival abscess, sclera-uveitis and occlusive vasculitis. There were no symptoms suggestive of pulmonary tuberculosis in all cases. All patients presented with acute, unilateral painful red eye. The first case had good visual acuity (VA) OD (6/9) with a swollen upper lid, localized perilimbal-hemorrhagic conjunctival swelling superiorly, keratic precipitates and mild anterior chamber reaction. The posterior segment was normal. The second case had a VA of 6/60 OD. There was presence of conjunctival injection, keratic precipitates, posterior synechiae and anterior chamber reaction of 1+. A few days later, there was a progression to vitritis OU and hyperemic optic disc OD with choroidal folds, cystoid macula edema and a positive T sign on B scan ultrasonography. The third case had VA of 6/6 OU, AC reaction of 2+ OD. There was multiple peripheral choroiditis with peripheral vasculitis seen in the posterior segment OU. Fundus fluorescein angiography (FFA) showed peripheral periphlebitis in all 4 quadrants OU. All 3 cases had positive Tuberculin Skin Test (Mantoux test) results which were more than 20mm. Anti-tuberculous treatment was promptly started and all patients showed significant clinical improvement. This case series highlights the diverse clinical presentations of ocular tuberculosis. A high clinical index of suspicion led to prompt initiation of anti-tuberculous therapy which resulted in good clinical outcomes for all cases.

Matched MeSH terms: Anterior Chamber
Complications in cataract surgery

Singh K

Med J Malaysia, 1976 Sep;31(1):38-41.
PMID: 1088175
Matched MeSH terms: Anterior Chamber
Fulltext Dislocated posterior chamber intraocular lens (PCOIL) in patients with retinitis pigmentosa (RP)

Lam, C.S., Mushawiahti, M., Bastion, M.L.C.

Journal of Surgical Academia, 2017;7(1):38-42.
MyJurnal

Subluxation or dislocation of PCIOL is one of the complications of cataract operation in RP patients. This paper reports the presentation of PCIOL dislocation and subluxation and the management and outcome in 3 eyes of 2 RP patients. Two medical records of patients with RP who developed dislocated or subluxated PCIOL and subsequently underwent explantation of the dropped IOL were evaluated. Two patients had bilateral eye cataract operation done and had PCIOL implanted. Patient 1 developed left eye subluxated PCIOL inferiorly after 2 years of the cataract operation and right eye dislocated PCIOL anteriorly 4 years after cataract operation. Patient 2 develop right eye subluxated PCIOL inferiorly after 12 years of the cataract operation. Patient 1 with right eye dislocated PCIOL underwent intraocular lens (IOL) explantation and was left aphakic as her visual prognosis was poor due to advanced RP. The left IOL remained within the visual axis despite subluxation and no intervention has been done. Patient 2 with right eye subluxated PCIOL underwent IOL explantation and anterior chamber intraocular lens (ACIOL) implantation. ACIOL remained stable and visual acuity improved post-operation. Both the operations were uneventful. Post-operatively, there was no elevated intraocular pressure and no prolonged ocular inflammation, which required prolonged anti-inflammatory and no retinal detachment was seen. Both patient and surgeon should be aware of potential PCIOL subluxation or dislocation in RP. The presentation may be as late as more than a decade after the cataract operation.

Matched MeSH terms: Anterior Chamber
Fulltext Herpes Zoster Ophthalmicus, persistent hyphema and orbital apex syndrome; a blinding combination

Shavani, Abirami, Adil Hussein, Wan-Hazabbah W.H.

Journal of Biomedical and Clinical Sciences, 2017;2(2):48-51.
MyJurnal

To report a rare case of an elderly gentleman who presented with herpes zoster ophthalmicus, complicated with persistent hyphema and orbital apex syndrome. A 75-year-old Malay gentleman presented with left herpes zoster ophthalmicus that was complicated with complete ophthalmoplegia and ptosis. He developed total hyphema in the affected eye with a secondary elevated intraocular pressure after a week. He was treated with oral acyclovir and topical corticosteroids. However, the total hyphema persisted that required an anterior chamber washout surgery. Herpes Zoster Ophthalmicus complicated with persistent hyphema and orbital apex syndrome is rare and very challenging to manage. Radiological imaging is important to exclude other causes of OAS. It is recommended to treat HZO with systemic acyclovir for a longer duration in view of ocular and neurological involvement.

Matched MeSH terms: Anterior Chamber

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