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Richard Gans, Justis Ehlers, William Dupps, Gina Smith, Peter Kaiser, Sunil Srivastava; Intraoperative and perioperative OCT findings of cataract surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1847.
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© ARVO (1962-2015); The Authors (2016-present)
Intraoperative spectral domain can provide novel information of micrscopic changes that occur during ophthalmic surgery. Its use during corneal and retinal surgery have described novel findings in the microstructure of the eye. The purpose of this paper is to describe the OCT findings during cataract surgery.
24 cataract surgery patients were identified whom intraoperative and/or perioperartive OCT was performed. 20 had traditional cataract surgery performed while 4 had femtosecond laser assisted cataract surgery. Images obtained were reviewed at several time points including pre-operatively, after the capuslarrhexis, after IOL placement and post-operatively. Images were obtained of several structures, including the cornea and capsular bag.
Intraoperative SD-OCT was successfully performed on all patients. All 24 patients revealed changes in the anterior lens structure after capsulorhexis with an eruption of lens material anteriorly into the anterior chamber. Capsulorhexis performed manually created a curved remnant of anterior capsule, while those performed with the femtosecond laser demonstrated sharp edges. IOL position often shifted during surgery and microscopic folding of the bag was noted in all cases. Post-operatively, the distal corneal wound was found to be open in some cases with a small descemet's detachment while for most femtosecond cases, the wound was noted to be closed
Intraoperative SD-OCT is feasible during cataract surgery. Findings reported here include the presence of the lens changes after the capuslorrhexis, the change in the shape of the edge of the anterior capsule and the shift in IOL position during cataract surgery. Additionally, post-operative imaging revealed microscopic opening of the distal corneal wound which was less common in the those performed by femtosecond laser.
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