Preoperative and postoperative size and movements of the lens capsular bag: ultrasound biomicroscopy analysis.

Purpose: To evaluate capsular bag size and accommodative movement before and after cataract surgery using ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT).

Setting: Ophthalmology Unit, Fabia Mater Clinic, Rome, Italy.

Design: Cohort study.

Methods: Eyes having cataract surgery and monofocal intraocular lens (IOL) implantation were studied using UBM. The following parameters were measured preoperatively and 1, 2, and 12 months postoperatively: anterior chamber depth (ACD) (also by AS-OCT), capsular bag thickness, capsular bag diameter, ciliary ring diameter, sulcus-to-sulcus (STS) diameter, ciliary process-capsular bag distance, ciliary apex-capsular bag plane, and IOL tilting. The preoperative and postoperative capsular bag volumes were calculated at 12 months. The results were compared with the changes during accommodation.

Results: The study comprised 24 eyes. With the exception of the ciliary apex-capsular bag plane, which appeared to be unmodified postoperatively, all measured parameters showed significant variation after IOL implantation. Only the ACD did not change significantly during accommodation.

Conclusions: After cataract surgery, the capsular bag stretched horizontally and with reduced vertical diameter as a result of adaptation to the implanted IOL. The capsular bag-IOL complex filled all available space, compressing the zonular fibers and almost abolishing the space between the ciliary apex and the capsular bag. There was anterior chamber deepening and a decrease in the ciliary ring diameter and STS diameter. In the absence of zonular fiber tension, the shape of the ciliary processes may be modified.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.