Incorporating Optical Coherence Tomography in the Cataract Preoperative Armamentarium: Additional Need or Additional Burden?
| Autor: | P. Vasudev, Mamidipudi R. Praveen, Viraj A. Vasavada, Deepak Bhojwani, C.V. Gopal Raju, Shraddha Jain, Aditya Sudhalkar |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Visual acuity genetic structures medicine.medical_treatment Visual Acuity India Intraocular lens Cataract Extraction Vitreomacular traction Fundus (eye) Preoperative care Asymptomatic Cataract 03 medical and health sciences 0302 clinical medicine Lens Implantation Intraocular Retinal Diseases Cataracts Ophthalmology Preoperative Care medicine Humans Prospective Studies Aged 030304 developmental biology Aged 80 and over 0303 health sciences business.industry Middle Aged Cataract surgery medicine.disease eye diseases 030221 ophthalmology & optometry Female sense organs medicine.symptom business Tomography Optical Coherence |
| Zdroj: | American Journal of Ophthalmology. 198:209-214 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2018.10.025 |
| Popis: | Purpose To determine the usefulness of preoperative optical coherence tomography (OCT) examination to detect asymptomatic macular abnormalities in patients scheduled for cataract surgery. Methods Design : Prospective, interventional case series. Setting : Iladevi Cataract and Visakha Eye Center, Ahmedabad, India. Study Population : Patients undergoing cataract surgery and intraocular lens (IOL) implantation for senile cataracts. Preoperatively no retinal/macular pathology was identified on clinical evaluation. Intervention : All eyes underwent macular 5-line raster evaluation using spectral-domain OCT before and after cataract surgery (monthly for 3 months). Central subfield thickness (CST) analysis was done. Outcome Measures : The primary outcome measure was determining the incidence of asymptomatic retinal lesions on OCT examination in clinically “normal” maculas. Secondary outcome measures included documenting change in corrected distance visual acuity and OCT thickness postoperatively. Results A total of 1444 eyes were evaluated. OCT revealed asymptomatic lesions in 133 (9.21%) patients. At 3 months, all eyes showed significant median visual improvement (from 0.45 ± 0.13 logMAR to 0.06 ± 0.08 logMAR; P = .015) and insignificant median CST change (from 223.34 ± 21.1 μm to 249.12 ± 19.24 μm; P = .19). One eye showed increased vitreomacular traction (3 months). Patients with asymptomatic lesions did not have significantly worse postoperative visual outcomes at 3 months (from 0.52 ± 0.16 logMAR to 0.14 ± 0.1 logMAR; P = .12). Conclusion A total of 9.21% patients with clinically normal maculas had subtle pathology detected on OCT, but this subset of patients did not have worse postoperative visual outcomes compared to eyes with normal OCT scans. Thus, a careful pre–cataract surgery fundus examination remains an essential part of the presurgical patient evaluation. |
| Databáze: | OpenAIRE |
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