Short-term fluctuation of lens corneal distance and clinical correlation with phacodonesis

  • Dhivya Ashok Kumar
  • Soundari Sivangnanam
  • Amar Agarwal
  • Sumaiya Banu Samiullah
  • Sanjiv Das
Cornea
First Online:
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Abstract

Background

To analyze the role of short-term lens–corneal distance (LCD) fluctuation in quantifying preoperative phacodonesis and predicting intraoperative zonular weakness.

Methods

Patients were divided into control (lens without clinical phacodonesis) and study (lens with suspicious and clinical phacodonesis) groups for evaluation. Slit-lamp examination followed by IOLMaster (Carl Zeiss) for LCD assessment was performed. Five readings were taken at five time points (0 s, 15 s, 30 s, 45 s & 60 s) continuously over a minute (short term) for the LCD fluctuation calculation.

Results

A total of 135 eyes (82 controls and 53 study) were assessed. Study group included 32 (60.3%) suspicious and 21 (39.6%) moderate to severe phacodonesis. There was difference between the control and study eyes (p = 0.000) in short-term LCD fluctuation. Twenty-one study eyes (39.6%) showed LCD difference > 1 mm, including 11 eyes (52.3%) with > 2 mm. There was a difference in LCD with respect to severity of phacodonesis (p = 0.000). In the study eyes, 13 eyes underwent glued IOL implantation (clinical phacodonesis — ten, suspicious phacodonesis — three), and two eyes (suspicious phacodonesis) had glued capsular hook. Thirteen eyes (clinical phacodonesis — ten, suspicious phacodonesis — three) required intraoperative vitrectomy due to vitreous ingress. Intraoperative zonular weakness in 62.5% of eyes with suspicious donesis and association (Chi-square = 0.000) of weakness with preoperative LCD fluctuation was noted.

Conclusions

Short-term lens–corneal distance fluctuation can be used as a parameter for quantifying lens stability and as an aid in assessing the intraoperative risk.

Keywords

Phacodonesis Lens–corneal distance (LCD) Short-term fluctuation in LCD Lens stability Lens movement 
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Notes

Funding

No funding was received for this research.

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name the institution/committee) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Dhivya Ashok Kumar
    • 1
  • Soundari Sivangnanam
    • 1
  • Amar Agarwal
    • 1
  • Sumaiya Banu Samiullah
    • 1
  • Sanjiv Das
    • 1
  1. 1.Dr. Agarwal’s Eye Hospital and Eye Research CentreChennaiIndia

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