Elucidating intraoperative dynamics and safety in posterior polar cataract with intraoperative OCT-guided phacoemulsification
| Autor: | Manpreet Kaur, Deeksha Rani, Jeewan S Titiyal, Farin Shaikh, Lalit M. S. Bageshwar |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
genetic structures medicine.medical_treatment Visual Acuity India Intraocular lens Dehiscence Cataract 03 medical and health sciences 0302 clinical medicine Primary outcome Lens Implantation Intraocular Anterior Eye Segment Ophthalmology medicine Humans Prospective Studies Retrospective Studies Phacoemulsification business.industry Significant difference Sensory Systems Posterior polar cataract Posterior capsule 030221 ophthalmology & optometry Surgery New delhi business Tomography Optical Coherence 030217 neurology & neurosurgery |
| Zdroj: | Journal of Cataract and Refractive Surgery. 46:1266-1272 |
| ISSN: | 1873-4502 0886-3350 |
| DOI: | 10.1097/j.jcrs.0000000000000256 |
| Popis: | Purpose To evaluate morphological characteristics and intraoperative dynamics of posterior polar cataract (PPC) using intraoperative optical coherence tomography (iOCT). Setting Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Design Prospective interventional study. Methods Forty eyes with PPC undergoing phacoemulsification were evaluated. Primary outcome measure was morphology of PPC and intraoperative dynamics of posterior capsule (PC). Secondary outcome measure was PC rent, which was retrospectively compared with 72 PPC cases that underwent non-iOCT-guided surgery. Results Of the 40 eyes evaluated, 3 morphological variants of PPC were observed: type I (19/40 [47.5%]) characterized by intact PC and clearance between PC and opacity, type II (12/40 [30%]) with intact PC in periphery of opacity, shadowing, and inability to detect PC in the center, and type III (9/40 [22.5%]) with dense opacity, extensive shadowing, and inability to delineate PC. In addition to hydrodelineation, hydrodissection was performed in all cases of type I PPC. In types II and III PPC, only hydrodelineation was performed. No case with type I opacity developed PC dehiscence. Three cases (7.5%) with types II (1 eye) and III (2 eyes) PPC developed PC dehiscence during aspiration of epinuclear cushion. Intraocular lens was implanted in all cases in the bag or sulcus. There was no significant difference in PC dehiscence between iOCT-guided and non-iOCT-guided surgery (P = .7). Conclusions iOCT-guided surgery helps to elucidate intraoperative dynamics in PPC and assess real-time PC integrity. It characterizes high-risk morphological features, enables safe hydrodissection in a subset of PPC, but does not decrease the incidence of PC dehiscence. |
| Databáze: | OpenAIRE |
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