Abstract
Purpose :
Evaluation of the clinical significance of dynamic spectral-domain intraoperative optical coherence tomography (iOCT) in cataract surgery with the implantation of various types of intraocular lenses (IOL) during the learning process.
Methods :
In this prospective observational study, imaging data from 151 patients undergoing iOCT-assisted cataract surgery with the implantation of different types of IOL were analyzed. The Rescan® 700 (Zeiss, Oberkochen, Germany) was used for iOCT, and images and video data were captured with the CALLISTO eye 3.2 system. Patients were divided based on the surgical technique and IOL type: 1. 101 eyes with conventional foldable IOL lens-in-bag technique (LIB); 2. 15 eyes with bag-in-the-lens IOL technique (BIL); 3. 5 eyes with Iris-claw IOL (ICL); 4. 15 eyes with suture less intrasclerally fixated three-piece IOL (TPL); 5. 15 eyes with suture lessintrasclerally fixated Carlevale IOL (CAL). The data were post-processed and statistically analyzed.
Results :
LIB: iOCT demonstrated the separation of the epinucleus from the posterior capsule after hydrodissection and the separation of the nucleus from the epinucleus after hydrodelineation. In 11% of cases, incomplete closure of the paracentesis occurred in the middle part of the corneal incision. BIL: iOCT imaging of the detached anterior hyaloid and correct implantation of the edges of the anterior continuous curvilinear capsulorhexis (ACCC) and posterior continuous curvilinear capsulorhexis (PCCC) into the groove of the BIL IOL. iOCT enabled imaging the iris after pupil constriction at the end of the operation. iOCT ensured control of the iris fold thickness and the IOL optic position after fixing the ICL. iOCT allowed control of the position of the optics of TPL IOL and CAL in relation to the iris and correct position of the haptics in the intrascleral space.
Conclusions :
The data demonstrated satisfactory visualization of the surgical field during iOCT-assisted cataract surgery with the implantation of various types of IOLs. This can reduce the risk of posterior capsule injury during phacoemulsification. Correct implantation of alternative to LIB IOLs is crucial to avoid postoperative complications and enable optimal IOL performance. The use of iOCT during the learning process can reduce intra- and postoperative complications during implantation of various types of IOLs.
This abstract was presented at the 2024 ARVO Imaging in the Eye Conference, held in Seattle, WA, May 4, 2024.