Postoperative Flat Anterior Chamber

Author: James V Aquavella, MD; Chief Editor: Hampton Roy Sr, MD more...

Updated: Feb 16, 2010

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Background
Pathophysiology
Epidemiology
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Background

Anterior chamber depth as ascertained by slit lamp examination has long been used as an important parameter in assessing postoperative status following major intraocular surgery. Prior to the second half of the 20th century, most cataract extractions and corneal transplantations were performed without the placement of edge-to-edge ophthalmic sutures. Therefore, a formed anterior chamber signified the reestablishment of the integrity of the globe sufficiently to impede or eliminate the leaking of aqueous humor. A shallow (or absent) anterior chamber can occur in the early, intermediate, or late postoperative period. This article defines the early postoperative period (days 1-7), the intermediate postoperative period (days 7-30), and the late postoperative period (in excess of 30 days).

Pathophysiology

In the early postoperative period, a shallow anterior chamber is often associated with a soft eye, but it may also be present with normal or even elevated intraocular pressure. The combination of a soft eye and a shallow anterior chamber occurring within the first several days following intraocular surgery often signifies a leak of aqueous fluid from the anterior chamber through the operative wound. Presence of a wound leak can be ascertained at the slit lamp with application of fluorescein dye to the wound site. Slight pressure on the globe results in a clearly visible flow of fluid (Seidel positive).

Frequency

United States

No good statistical data are available on the frequency of occurrence. Clearly, the condition is encountered more frequently in glaucoma^[1]and corneal transplantation than in routine cataract extraction. The highest overall incidence may be following repair of extensive perforating injuries.

International

Difference in frequency internationally will be related to the availability of state-of-the-art microsurgical technology and equipment, including sutures and instruments. Yet, no objective statistical evidence has been reported.

Mortality/Morbidity

The condition is strictly related to the globe and is not associated with mortality or systemic morbidity.

Race

No data are available relating to racial difference in frequency or severity.

Sex

No differences are anticipated in frequency between males and females.

Age

No data are available.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

James V Aquavella, MD Professor of Ophthalmology, Department of Ophthalmology, University of Rochester School of Medicine, University of Rochester Eye Institute

James V Aquavella, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, Contact Lens Association of Ophthalmologists, and International College of Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Gregory J McCormick, MD Consulting Staff, Corneal and Refractive Surgery, Vermont Laser Vision at Timber Lane and Ophthalmic Consultants of Vermont

Gregory J McCormick, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery, and Medical Society of the State of New York

Disclosure: Nothing to disclose.

Specialty Editor Board

Bradford Shingleton, MD Assistant Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary

Bradford Shingleton, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association

Disclosure: Nothing to disclose.

Lance L Brown, OD, MD Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

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