Role of anterior segment optical coherence tomography for safer management of mature white cataracts

Abstract

Role of anterior segment optical coherence tomography (AS-OCT) for safer management of mature white cataracts. Patients with mature white cataracts attending the outpatient department of a tertiary eye care hospital, aspiring to have cataract surgery performed, were scheduled for elective phacoemulsification and intraocular lens implantation by two surgeons during the period of October 2017 to March2018. A prospective interventional study of 30 patients. All patients with mature cataracts and absence of any retinal pathology had AS-OCT to assess the presence or absence of intralenticular subcapsular fluid pockets. The patients with thepresence of subcapsular fluid pockets (Group 1) underwent 30-gauge needle aspiration fluid aspiration followed by capsulorhexis and phacoemulsification and those without any fluid (Group 2) underwent Utrata forceps-assisted capsulorhexis. The study comprised 30 eyes of 30 patients, of which15eyes (50%) had subcapsular fluid and 15 eyes (50%) had no fluidon AS-OCT. Of the 15 eyes in Group 1, 13 eyes (86.7%) underwent complete circular curvilinear capsulorhexis (P=.001), with a surgical success rate of 87%, whereas 2eyes (13.3%) hadcapsular runaway complications. Of the 15 eyes with no subcapsular fluid, 13 eyes (86.7%) underwent complete circular curvilinear capsulorhexis (P=.001), whereas 2 eyes (13.3%) had posterior capsule rupture. Thus, 87% of the cases had uneventful capsular outcomes in each group. The detection of subcapsular fluid on AS-OCT allows better planning and management with 30-gauge assisted-needle drainage of fluid, thus decreasing the chances for capsular runaway complications with better surgical outcomes.