AS-OCT helps predict intraoperative issues in posterior subcapsular cataract procedures

Anterior segment optical coherence tomography (AS-OCT) is a highly effective tool for preoperatively assessing posterior subcapsular cataracts (PSC), according to a study, allowing for accurate prediction of intraoperative complications, such as posterior capsular plaque (PCP) and rupture (PCR), based on the morphology of the lens.

The study used AS-OCT to examine the posterior capsule and associated lens opacities using Line, Cross Line, and 3D Cornea scans on 512 eyes with PSC.

The eyes were categorized into 3 groups based on the morphological changes detected by AS-OCT: Group 1 (n = 312) with minimal changes, Group 2 (n = 185) with moderate changes, and Group 3 (n = 15) with significant changes. Each group underwent ultrasound phacoemulsification and intraocular lens implantation, with surgical measures adjusted according to the PSC type.

Group 1 had no intraoperative posterior capsular plaque or rupture, Group 2 had 100% incidence of PCP, and Group 3 had 46.7% PCP and 53.3% PCR. The study found a strong correlation between preoperative AS-OCT findings and the incidence of intraoperative complications (r = 0.88, P ≤ 0.001). AS-OCT showed a sensitivity of 98.8% and specificity of 96.5% in predicting complications.

Reference
Lutsenko N, Isakova O, Rudycheva O, et al. Preoperative OCT lens evaluation in posterior subcapsular cataract – prevention of complications from phacoemulsification. Graefes Arch Clin Exp Ophthalmol. 2024;doi: 10.1007/s00417-024-06632-5. Epub ahead of print. PMID: 39243286.