Evaluation of role of ophthalmic ultrasonography in ophthalmic examination precataract surgery

Abstract

Aim: The aim of this study is to determine the importance of ophthalmic ultrasonography in investigation before cataract surgery, with a view to identify common posterior segment lesions in elderly patients. Subjects and Methods: A cross-sectional prospective study was conducted at AlNeelain University Eye Hospital, Khartoum, Sudan, on 220 eyes of 220 elderly patients (50–90 years) with senile cataract in one eye in the period from January to September 2018. Grade of cataract was evaluated using the slit-lamp examination. A-scan biometry and B-scan ultrasonography were taken before cataract surgery using Echo Scan (Nidek, US-4000). High gain (80–120 dB) and medium gain (50–70 dB) sensitivity were used. Dynamic B-scan was used to enhance differential diagnosis in cases with vitreous changes. Results: The mean age of the sample was 60.46 ± 10.64 years with 120 males and 100 females. Grade of cataract reported was as follows: 40% Grade II, 50% Grade III, and 10% Grade IV. Visual acuity (VA) had a negative correlation with grade of cataract (P < 0.001). All patients had visual impairment before cataract surgery with a mean VA of 0.10 ± 0.17. Posterior lesions detected were as follows: Asteroid hyalosis (22.73%), vitreous haemorrhage (10%), posterior staphyloma (7.27%), posterior vitreous detachment (6.36%), retinal detachment and retinoschisis (4.55% each), and ciliary body tumor (1.82%). Conclusion: Most common posterior segment lesion found in elderly patients is asteroid hyalosis, while ciliary body tumor is the only neoplastic lesion found. Ophthalmic ultrasonography is essential for the detection of undetected posterior segment lesions in eyes with dense cataract and is recommended to be done routinely before cataract surgery.