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Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections

PURPOSE: To investigate the dependence of the ciliary body length (CBL) on the axial length (AL) and to draw conclusions on implications regarding safe pars plana access for intravitreal injections and vitreoretinal surgery. METHODS: A total of 200 individuals (mean age 42 years, SD ± 15.4) were enr...

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Autores principales: Lincke, Joel-Benjamin, Keller, Salome, Amaral, Joao, Zinkernagel, Martin S., Schuerch, Kaspar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166736/
https://www.ncbi.nlm.nih.gov/pubmed/33074373
http://dx.doi.org/10.1007/s00417-020-04967-3
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author Lincke, Joel-Benjamin
Keller, Salome
Amaral, Joao
Zinkernagel, Martin S.
Schuerch, Kaspar
author_facet Lincke, Joel-Benjamin
Keller, Salome
Amaral, Joao
Zinkernagel, Martin S.
Schuerch, Kaspar
author_sort Lincke, Joel-Benjamin
collection PubMed
description PURPOSE: To investigate the dependence of the ciliary body length (CBL) on the axial length (AL) and to draw conclusions on implications regarding safe pars plana access for intravitreal injections and vitreoretinal surgery. METHODS: A total of 200 individuals (mean age 42 years, SD ± 15.4) were enrolled in the study. Objective refraction and AL were obtained. Spherical equivalent (SE) was calculated. Anterior segment optical coherence tomography (ASOCT) was used to image and measure the CBL. RESULTS: The mean SE was − 1.64 diopters (SD ± 3.15, range − 14.5 to + 9 diopters) and the mean AL was 24.19 mm (SD ± 1.65, range 19.8–32.2 mm). There was a significant correlation between SE and AL (r(2) = 0.62, p < 0.0001). Mean CBL correlated significantly with age (r(2) = 0.11, p < 0.0001), AL (r(2) = 0.23, p < 0.0001) and SE (r(2) = 0.25, p < 0.0001). The mean CBL was 3351 μm (SD ± 459, range 2184–4451 μm). Three separate groups were defined by their AL with a normal AL group (AL 22.5 to 25 mm), a short AL group (AL < 22.5 mm) and a long AL group (AL > 25 mm). The mean CBL in the normal AL group was 3311 μm (SD ± 427), in the short AL group 2936 μm (SD ± 335) and in the long AL group 3715 μm (SD ± 365), and differed significantly (p < 0.0001) when compared. CONCLUSION: For interventions requiring pars plana access (as an intravitreal injection or vitreoretinal surgery), an incision distance of 3.5–4.0 mm posterior to the limbus is recommended. In our research, however, a difference of 0.77 mm in mean CBL between the group with short AL and the group with long AL is demonstrated, implying that the mean CBL in very short and very long eyes differs significantly. These findings suggest that the AL should be taken into account for pars plana access and that it would be advisable to prefer the shorter or longer recommended distance (3.5 and 4.0 mm, respectively) from the limbus, which correlates with the AL. If AL is > 25 mm, a distance of 4.0 mm from the limbus should be chosen; and if AL is < 22.5 mm, a distance of 3.5 mm seems adequate. TRIAL REGISTRATION NUMBER AND DATE: NCT00564291, 27 Nov 2007 [Image: see text]
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spelling pubmed-81667362021-06-03 Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections Lincke, Joel-Benjamin Keller, Salome Amaral, Joao Zinkernagel, Martin S. Schuerch, Kaspar Graefes Arch Clin Exp Ophthalmol Retinal Disorders PURPOSE: To investigate the dependence of the ciliary body length (CBL) on the axial length (AL) and to draw conclusions on implications regarding safe pars plana access for intravitreal injections and vitreoretinal surgery. METHODS: A total of 200 individuals (mean age 42 years, SD ± 15.4) were enrolled in the study. Objective refraction and AL were obtained. Spherical equivalent (SE) was calculated. Anterior segment optical coherence tomography (ASOCT) was used to image and measure the CBL. RESULTS: The mean SE was − 1.64 diopters (SD ± 3.15, range − 14.5 to + 9 diopters) and the mean AL was 24.19 mm (SD ± 1.65, range 19.8–32.2 mm). There was a significant correlation between SE and AL (r(2) = 0.62, p < 0.0001). Mean CBL correlated significantly with age (r(2) = 0.11, p < 0.0001), AL (r(2) = 0.23, p < 0.0001) and SE (r(2) = 0.25, p < 0.0001). The mean CBL was 3351 μm (SD ± 459, range 2184–4451 μm). Three separate groups were defined by their AL with a normal AL group (AL 22.5 to 25 mm), a short AL group (AL < 22.5 mm) and a long AL group (AL > 25 mm). The mean CBL in the normal AL group was 3311 μm (SD ± 427), in the short AL group 2936 μm (SD ± 335) and in the long AL group 3715 μm (SD ± 365), and differed significantly (p < 0.0001) when compared. CONCLUSION: For interventions requiring pars plana access (as an intravitreal injection or vitreoretinal surgery), an incision distance of 3.5–4.0 mm posterior to the limbus is recommended. In our research, however, a difference of 0.77 mm in mean CBL between the group with short AL and the group with long AL is demonstrated, implying that the mean CBL in very short and very long eyes differs significantly. These findings suggest that the AL should be taken into account for pars plana access and that it would be advisable to prefer the shorter or longer recommended distance (3.5 and 4.0 mm, respectively) from the limbus, which correlates with the AL. If AL is > 25 mm, a distance of 4.0 mm from the limbus should be chosen; and if AL is < 22.5 mm, a distance of 3.5 mm seems adequate. TRIAL REGISTRATION NUMBER AND DATE: NCT00564291, 27 Nov 2007 [Image: see text] Springer Berlin Heidelberg 2020-10-19 2021 /pmc/articles/PMC8166736/ /pubmed/33074373 http://dx.doi.org/10.1007/s00417-020-04967-3 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Retinal Disorders
Lincke, Joel-Benjamin
Keller, Salome
Amaral, Joao
Zinkernagel, Martin S.
Schuerch, Kaspar
Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
title Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
title_full Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
title_fullStr Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
title_full_unstemmed Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
title_short Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
title_sort ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections
topic Retinal Disorders
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166736/
https://www.ncbi.nlm.nih.gov/pubmed/33074373
http://dx.doi.org/10.1007/s00417-020-04967-3
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