Optical coherence tomography in patients undergoing cataract surgery

Abstract

Approved by the following research ethics committee: Federal University of Paraná (UFPR), 654.007. ABSTRACT Purpose:To assess the ability of spectral domain optical coherence tomography (SD-OCT) to diagnose macular changes pre-and post-cataract surgery and to identify changes in central foveal thickness (CFT) relative to age, sex, and presence of concomitant ophthalmic pathologies, for a period of 6 months post-surgery. Methods: A prospective study of patients evaluated by SD-OCT within 5 h before surgery at 7, 30, 60, 90, and 180 days post-op, with respect to CFT and presence of maculopathy. Results: Ninety-eight eyes of 98 patients were evaluated, with the following mean results: age = 71.4 years, pre-op VA = 0.27 logMAR, and final VA = 0.73 logMAR. There were 21 eyes in patients with diabetes mellitus (DM) and 10 eyes with age-related macular degeneration (AMD), three with epiretinal membrane, and four with glaucoma. Sixty eyes had no other ophthalmic-related pathologies (NOO), and had a mean pre-op CFT of 222 µm, which progressively increased up to the 60 th day post-op, reaching a mean of 227.2 µm. No pseudophakic cystoid macular edema was observed. The mean CFT was statistically significantly different (p<0.001) between NOO and diabetic patients from 30 days post-op. Four eyes presented with preoperative diagnosis of AMD as measured by ophthalmoscopy. After completion of the OCT, which was performed within 5 h before surgery, six additional patients were found to have AMD. Of the 98 total eyes, 10 were diagnosed with maculopathy only by OCT exam. Binocular indirect ophthalmoscopy (BIO) was unable to detect such changes. Conclusion: OCT diagnosed preoperative maculopathies in 21.4% of the patients, and was more effective than BIO (11.2%). OCT showed a progressive increase in CFT in diabetics up to 180 days post-operatively, as well as greater CFT in male patients and patients older than 70 years.

Macular assessment of preoperative optical coherence tomography in ageing Chinese undergoing routine cataract surgery

“…Moreira Neto et al . 12 investigated 98 patients undergoing cataract surgery; they diagnosed preoperative maculopathies in 21.4% of the patients with SD-OCT, which was a larger percentage than that detected with binocular indirect ophthalmoscopy (11.2%). In that study, patients with clinically detectable macular pathologies also were included.…”

Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes

“…Bozkurt et al have shown that intracameral injection of 0.2 mL epinephrine (1:5,000) did not increase the risk of central macular edema in eyes with no risk factors that had uneventful phacoemulsification with intraocular lens implantation 39. However, patients with diabetes are prone to the development of macular edema postoperatively with the use of epinephrine 40,41. None of the patients in our study had developed macular edema at the 3-month follow-up.…”

Macular optical coherence tomography before cataract surgery

“…Spectral-domain OCT (SD-OCT) is the gold standard for diagnosing many macular abnormalities, including vitreomacular interface disorders. 3 4 5 6 However, many clinics do not routinely perform preoperative macular OCTs before cataract surgery unless macular findings were observed during a standard examination. 5 …”