Abstract
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. 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. 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 60th 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. 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.
Highlights
The outcome of cataract surgery is based on the technical quality of the procedure and the presence of other ophthalmic diseases or complications before, during, and after surgery.To identify the potential visual acuity (VA) to be achieved following surgery, and to identify other diseases that can affect the final result, various tests can be performed depending on the clinical situation at hand, such as the measurement of potential VA and the use of binocular indirect ophthalmoscopy (BIO), etc
The current study evaluates the ability of spectral domain optical coherence tomography (SD-optical coherence to mog raphy (OCT)) to detect pre- and postoperative
All patients signed an informed consent form. This prospective, analytical, observational, longitudinal study included patients of the Unified Health System scheduled for phacoemulsification and intraocular lens (IOL) implantation
Summary
The outcome of cataract surgery is based on the technical quality of the procedure and the presence of other ophthalmic diseases or complications before, during, and after surgery. To identify the potential visual acuity (VA) to be achieved following surgery, and to identify other diseases that can affect the final result, various tests can be performed depending on the clinical situation at hand, such as the measurement of potential VA and the use of binocular indirect ophthalmoscopy (BIO), etc. Among other currently available ancillary exams for retinal evaluation, optical coherence to mog raphy (OCT) is the least invasive exam offering the most informa tion on the macula[1]. Submitted for publication: February 2, 2015 Accepted for publication: May 5, 2015 1 Hospital de Olhos do Paraná, Curitiba, PR, Brazil. 2 Department of Ophthalmology, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil OCT technology allows for observation of the retinal structures (ganglion cells, nerve fiber layer, photoreceptors), including the optic disc and fovea, and provides important diagnostic information for accurate evaluation of the macular area[2].
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