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Seyed Javad Hashemian MD Eye Research Center Rasoul Akram Hospital

In the name of GOD. Direct Measurement of the Ciliary Sulcus Diameter by Ultrasound Biomicroscopy and Correlation with White to White measurement. Seyed Javad Hashemian MD Eye Research Center Rasoul Akram Hospital Tehran University of Medical Sciences No financial interest

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Seyed Javad Hashemian MD Eye Research Center Rasoul Akram Hospital

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  1. In the name of GOD Direct Measurement of the Ciliary Sulcus Diameter by Ultrasound Biomicroscopy and Correlation with White to White measurement. SeyedJavadHashemian MD Eye Research Center RasoulAkram Hospital Tehran University of Medical Sciences No financial interest SJ_Hashemian@yahoo.com WWW.Drhashemian.com Tehran-IRAN ASCRS, San Diego, March /27/ 2011

  2. lens sizes & Correspondence between white-to-white and sulcus diameter • Published studies have not found any anatomical correspondence between white-to-white and sulcus diameter, suggesting that some lens sizing issues may be explained by the assumption that sulcus diameter can be estimated from white-to-white. • Posterior chamber phakic IOLs using a sizing criteria of adding 0.50 mm to the white-to-white in eyes where the anterior chamber depth (ACD) was 2.80 to 3.50 mm, and adding 1.00 mm to the white-to-white in eyes where the ACD was >3.50 mm. • The common theme regarding postoperative complications of posterior chamber phakic IOL surgery is that of lens sizing • An oversized lens can cause angle closure leading to malignant glaucoma, or the lens can chafe the iris leading to pigment dispersion • An undersized lens can cause cataract or damage to the zonules with dislocation of the phakic IOL Recently, a 35-MHz UBM was developed, and this device seems to be more accurate than other methods because it can measure ciliarysulcus diameter from 1 image, even though the image resolution is not as good as that of 50-MHz UBM. In the present study, we measured ciliarysulcus diameters using a 35-MHz UBM and evaluated the correlation with white-to-white distances.

  3. PURPOSES : To evaluate the correlation of white to white measurement between Caliper and Orbscan and relation to sulcus to sulcus dimension measured by UBM. In this cross-sectional observational study we measured sulcus to sulcus dimension of 203 eyes of high myopic patients who presented to be assessed for phakic IOL surgery. we measured sulcus to sulcus dimension by UBM and horizontal white-to-white distance using Orbscan IIz and Caliper. Mean W-W dimension , differences between methods of measurement and correlation with S- to- S diameter was evaluated . • Horizontal white-to-white distances were measured by scanning slit topography using OrbscanIIz (Bausch & Lomb) UBM ciliarysulcus measurement • Topical tetracaine 0.5% was instilled to anesthetize the cornea before measurement. One of 3 differently sized eyecups (18 mm, 20 mm, and 22 mm) was inserted depending on the ocular aperture size. An eyecup was filled with sterile normal saline and the subject was asked to fixate on a ceiling target with the fellow eye to maintain accommodation and fixation. • Diameters of the ciliarysulcus were measured using a VuMax-II UBM equipped with a 35-MHz transducer. Cross-sectional images were obtained on the horizontal meridians. METHODS:

  4. RESULTS: • Mean W-W dimension in Caliper group was 11.63 mm ±0.38 mm ( range 10.8-12.5mm), • By Orbscan was 11.80mm ± 0.42 mm (range 10.5mm-13.2mm) . • Mean S-S dimension by UBM was 12.14mm ± 0.43mm ( range 11.07-13.37mm) • Mean difference of S-S and W-W by Caliper was 0.49mm±0.26mm ( range -0.18-1.65mm) • Mean difference of W-W by Orbscan – Caliper was 0.10mm ±0.25mm ( range -0.30-2.20mm). Correlation: • The correlation of white to white diameter measured by Caliper and Orbscanwith sulcus to sulcus dimension measured by UBM was 78.4% and 71%respectively.

  5. CONCLUSIONS: • The 35-MHz UBM is an accurate method for direct measurement of the ciliarysulcus diameter for proper determination of posterior chamber phakic IOL size • The White-to-white measurements by Caliper and Orbscan are an acceptable method to predict the ciliarysulcus diameter in myopic patients if UBM is not available.

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