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Nino Hirnschall, Sophie Tatzreiter, Yen-An Chen, Sahand Amir-Asgari, Oliver Findl; Predicting The Post-operative Intraocular Lens Position Using Optical Coherence Tomography During Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6718.
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Aim of this study was to assess, whether intra-operative measurements of the lens capsule with optical coherence tomography (OCT) can predict the post-operative intraocular lens (IOL) position.
This prospective study included patients who were scheduled for cataract surgery divided into 3 subgroups of emmetropic, myopic and hypermetropic eyes as defined by planned IOL power. A prototype operating microscope with an integrated anterior segment OCT device (Visante attached to OPMI VISU 200, Carl Zeiss Meditec AG, Germany) was used to measure the lens capsule position at different time points during cataract surgery. To improve the quality of the measurements, all patients received a capsular tension ring (CTR) during surgery to result in a taut the posterior lens capsule. Partial coherence interferometry (AC-Master) was used to measure anterior chamber depth (ACD) before and after surgery.
In total, 50 eyes of 50 patients were included. Mean axial eye length was 23.8mm (range: 20.6mm to 29.5mm), mean planned IOL power was 20.1D (range: 1D to 31D). The correlation between the phakic ACD measured pre-operatively with the AC-Master and the intra-OP measurement with the OCT at the beginning of surgery was r2=0.6 (p<0.05). In six of these cases the intra-op measurement was not centered on the cornea, as seen from the video image. With these cases excluded, the correlation was r2= 0.85 (p<0.05). The correlation between the post-operative pseudophakic ACD and the intra-operative measurements after implanting a CTR and after implanting the IOL showed a moderate correlation for the posterior capsule position, and a relatively good correlation for the anterior capsule position.
Intra-operative OCT allows qualitative morphological as well as quantitative biometric assessment of the anterior segment during surgery. This new surgical tool may help to enhance outcomes for patients undergoing cataract surgery.
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