ArticlePloS one2026
Comparable performance of 3D and 2D anterior segment optical coherence tomography in predicting intraocular pressure reduction following cataract surgery.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo develop predictive models using three-dimensional (3D) and conventional two-dimensional (2D) anterior-segment optical coherence tomography (AS-OCT) parameters for intraocular pressure (IOP) reduction following phacoemulsification in glaucoma and non-glaucoma cohorts.
methodsThis prospective study included patients with and without glaucoma who underwent phacoemulsification. Preoperative predictors of 1-month IOP reduction, including clinical, ocular biometry, and AS-OCT (CASIA2) parameters, were analyzed. 3D AS-OCT measurements were assessed in two approaches: (1) averaging 360-degree values and (2) estimating circumferential areas or volumes. 2D variables were obtained from horizontal cross-sectional images. Model selection with least absolute shrinkage and selection operator (LASSO) for 2D and 3D variables was performed separately. R-squared (R²) used to represent model accuracy. The performance was validated by bootstrap resampling.
resultsA total of 130 eyes (64 glaucoma, 66 non-glaucoma) from 103 patients were included. The average IOP change was -1.20 ± 3.29 mmHg. Preoperative IOP (preIOP) was the strongest single predictor across all models. In the entire cohort, the final models showed moderate predictability (R² 38% for 3D and 36% for 2D; optimism-corrected R² 31% for both). In glaucoma eyes, models incorporating AS-OCT angle status and anterior chamber width achieved R² values of 36% (3D) and 38% (2D), with optimism-corrected R² of 27% (3D) and 28% (2D). In non-glaucoma eyes, both 3D and 2D models showed higher predictability (R² 53%, optimism-corrected R² 45%), with final predictors incorporating AS-OCT anterior chamber area and iris thickness. Both 3D and 2D models significantly outperformed the reference preIOP models across all cohorts (all p > 0.05).
conclusionsAS-OCT parameters improved the predictability of IOP reduction after phacoemulsification, with notably better performance in non-glaucoma eyes. 2D and 3D models showed comparable predictive ability.
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