Translational vision science & technology · 2025
Ocular Biometric Predictors of Corneal Endothelial Contact by Intracameral Implants for Open-Angle Glaucoma and Ocular Hypertension.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Hong Alexander T, Yang Eric J, Duong Andrew, Apolo Galo, Nguyen Van D, Xu Benjamin Y
Аннотация
PURPOSE: To identify biometric factors predictive of corneal endothelial contact (CEC) by intracameral implants in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHTN).
METHODS: In this prospective observational study, patients with a chart diagnosis of POAG or OHTN without prior cataract or incisional glaucoma surgery were consecutively enrolled between August 2022 and October 2023. Participants underwent anterior segment optical coherence tomography (AS-OCT) imaging along the vertical meridian under dark and light conditions. An intracameral implant was simulated by overlaying a 0.2-mm-diameter circle onto an AS-OCT image of the inferior angle recess to predict CEC, defined as implant contact anterior to Schwalbe's line. Logistic regression models were developed to identify predictors of CEC.
RESULTS: CEC was present in 14 eyes (17.9%) and 11 eyes (14.1%) from 78 eyes of 78 participants in the dark and light conditions, respectively. In univariable analysis, smaller angle opening distance (750 µm; AOD750), shallower anterior chamber depth, greater lens vault and thickness, and iridotrabecular contact were significantly associated with CEC in both environments (P < 0.05). AOD750 was the strongest predictor of CEC (dark AUC = 0.99; light AUC = 0.97), with optimal cutoffs of 0.22 mm (dark) and 0.30 mm (light). Gonioscopy grade was less predictive of CEC (dark AUC = 0.79; light AUC = 0.84).
CONCLUSIONS: CEC by a simulated intracameral implant was predicted in a subset of patients with chart diagnosis of POAG or OHTN. AS-OCT biometrics were more strongly predictive of CEC than gonioscopy.
TRANSLATIONAL RELEVANCE: AS-OCT may enhance preoperative evaluation of intracameral implant candidates by identifying those at higher risk for CEC.
METHODS: In this prospective observational study, patients with a chart diagnosis of POAG or OHTN without prior cataract or incisional glaucoma surgery were consecutively enrolled between August 2022 and October 2023. Participants underwent anterior segment optical coherence tomography (AS-OCT) imaging along the vertical meridian under dark and light conditions. An intracameral implant was simulated by overlaying a 0.2-mm-diameter circle onto an AS-OCT image of the inferior angle recess to predict CEC, defined as implant contact anterior to Schwalbe's line. Logistic regression models were developed to identify predictors of CEC.
RESULTS: CEC was present in 14 eyes (17.9%) and 11 eyes (14.1%) from 78 eyes of 78 participants in the dark and light conditions, respectively. In univariable analysis, smaller angle opening distance (750 µm; AOD750), shallower anterior chamber depth, greater lens vault and thickness, and iridotrabecular contact were significantly associated with CEC in both environments (P < 0.05). AOD750 was the strongest predictor of CEC (dark AUC = 0.99; light AUC = 0.97), with optimal cutoffs of 0.22 mm (dark) and 0.30 mm (light). Gonioscopy grade was less predictive of CEC (dark AUC = 0.79; light AUC = 0.84).
CONCLUSIONS: CEC by a simulated intracameral implant was predicted in a subset of patients with chart diagnosis of POAG or OHTN. AS-OCT biometrics were more strongly predictive of CEC than gonioscopy.
TRANSLATIONAL RELEVANCE: AS-OCT may enhance preoperative evaluation of intracameral implant candidates by identifying those at higher risk for CEC.