Evaluation of anterior segment parameters in cataract patients with pseudoexfoliation before and after cataract surgery by anteri̇or segment optical coherence tomography

Purpose: We aimed to evaluate the anterior segment parameters of pseudoexfoliation cataract patients before and after cataract surgery, in the first week, first month and sixth month, by anterior segment optical coherence tomography (AS-OCT), optical biometry and specular microscopy for comparing the changes. Materials and Methods: In this study, 30 eyes of 30 patients who applied to Van Yüzüncü Yıl University Faculty of Medicine, Department of Ophthalmology outpatient clinic, were diagnosed with pseudoexfoliation cataract and subsequently underwent cataract surgery were included. Our study was designed as a prospective study. The patients we included in the study underwent a detailed preoperative examination, and then post-operative controls were performed during the first week, first month and sixth month. Patient's eye examinations were performed using AS-OCT, optical biometry, and specular microscopy. The images obtained using AS-OCT were transferred to the Image J program and the central corneal thickness (CCT), anterior chamber angle (ACA 500), angle opening distance (AOD 500, AOD 750), trabecular iris space area (TISA 500, TISA 750), Schlemm's canal area (SCA), Schlemm's canal diameter (SCD), iris stromal thickness (IST) values were measured as manual. Axial length (AU), pupil diameter (PD), mean keratometry (Km), and anterior chamber depth (ACD) values were measured by optical biometry, and endothelial cell density (ECD) was measured by specular microscopy and compared before and after cataract surgery. Results: Thirty eyes of a total of 30 patients, 19 males (63%) and 11 females (37%) with a mean age of 73.7±7.2 years, were examined. Best corrected visual acuity (BCVA), AOD 500-n, AOD 500-t, AOD 750-n, AOD 750-t, TISA 500-n, TISA 500-t, TISA 750-n, TISA 750-t, ACA 500-n, ACA 500-t and ACD values increased significantly in the postoperative period compared to the preoperative period (p<0.001). It was observed that there were significant increases in the parameters SCA-n, SCA-t, SCD-n, and SCD-t in postoperative measurements compared to preoperative measurements (p<0.05). CCT value in the postoperative first week was found to be significantly higher than the preoperative, postoperative first month and postoperative sixth-month CCT values (p<0.046). There were differences of significant degree between the preoperative, postoperative first month and postoperative sixth month values as statistical. A significant decrease was observed in intraocular pressure (IOP) and ECD parameters in postoperative measurements compared to preoperative measurements (p<0.01). There were no significant differences in the postoperative values of IST-n, IST-t, AL, Km, and PD compared to preoperative values. Conclusion: In our study, it was observed that phacoemulsification surgery caused significant changes in anterior segment parameters in pseudoexfoliation cataract cases in the postoperative first week, first month, and sixth month periods compared to the preoperative period. Keywords: Pseudoexfoliation syndrome, cataract, anterior chamber angle, anterior segment optical coherence tomography, Schlemm's canal, iris stromal thickness