December 2018

RESIDENTS

Can preoperative anterior segment optical coherence tomography predict posterior capsule rupture during phacoemulsification in patients with posterior polar cataract?


by Gurudatha Pavan Kumar, DNB, Palaniswamy Krishnamurthy, MS, Manas Nath, DO, Prabu Baskaran, MS, Muralikrishnan Janani, DNB, Rengaraj Venkatesh, DNB

J Cataract Refract Surg. 2018;44(12):1441–1445.

Purpose: To understand if preoperative assessment of posterior capsule integrity using anterior segment optical coherence tomography (AS-OCT) can predict posterior capsule dehiscence in patients with posterior polar cataract (PPC) undergoing phacoemulsification.
Setting: Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Pondicherry, India
Design: Prospective observational study
Methods: Eyes with PPC that underwent phacoemulsification were included in the study during the period between October 2012 and November 2013. Preoperative AS-OCT imaging was performed to assess the integrity of the posterior capsule. AS-OCT images of the posterior capsule were graded as “intact” or “dehiscent.” Phacoemulsification was performed by a single surgeon who was masked from AS-OCT findings. The integrity of the posterior capsule was evaluated by the surgeon intraoperatively.
Results: The study involved 64 eyes of 62 patients. Preoperative AS-OCT showed 8 (12.5%) eyes to have probable posterior capsular dehiscence and 56 (87.5%) eyes to have intact posterior capsule. Intraoperatively the surgeon noted posterior capsular dehiscence in 5 (7.8%) eyes and an intact posterior capsule in 59 (92.2%) eyes. The sensitivity and specificity of AS-OCT for detecting posterior capsular dehiscence was 100% and 94.92%, respectively. The negative predictive value of AS-OCT was 100%.
Conclusion: Anterior segment OCT with its high negative predictive value can be successfully utilized to predict the risk of posterior capsule rupture during phacoemulsification in eyes with PPC.

Can preoperative anterior segment optical coherence tomography predict posterior capsule rupture during phacoemulsification in patients with posterior polar cataract? Can preoperative anterior segment optical coherence tomography predict posterior capsule rupture during
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