Static and dynamic analysis of the anterior segment with optical coherence tomography

Purpose: To study biometric modifications of the anterior segment with accommodation and age and determine possible applications in areas of anterior segment surgery, particularly implantation of refractive lenses. Setting. Clinique Monticelli, Marseille, France. Method. The study comprised subjects between 7 years of age and 82 years of age in whom anterior chamber biometry was evaluated using 1310 nm wavelength optical coherence tomography (OCT). The equipment has a fixation target that can be focused and defocused with negative lenses to stimulate natural accommodation. All measurements were performed by the same operator. The horizontal diameter of the AC, the anterior chamber depth (ACD), the horizontal pupil diameter, and the horizontal radius of curvature of the crystalline lens' anterior pole were measured in the unaccommodated state and after stimulating accommodation. Results: Fifty-six subjects (104 eyes) were included; the refractions ranged from +5.0 diopters (D) to -5.0 D. The static and dynamic measurements were compared with ametropia, age, and accommodation. At rest, the mean AC diameter was 12.334 mm, the mean ACD was 3.106 mm, and the mean pupil diameter was 4.258 mm. With 1.0 D of accommodation, the anterior pole moved forward by a mean of 30 Km, the radius of curvature decreased 0.3 mm, and the pupil diameter decreased 0.15 mm. Conclusions: The AC OCT is a user-friendly instrument for evaluating the anterior segment and examining the AC (cornea, iris, crystalline lens, and iridocorneal angle). The 1310 nm light wavelength is blocked by pigments, preventing examination behind the iris. However, the AC OCT is capable of good image quality and visualization of the anatomical relationships in the anterior segment, even behind an opaque cornea.(C) 2004 ASCRS and ESCRS.