Optical coherence tomography for routine screening of preoperative macular pathology in patients scheduled for cataract surgery

Session Details

Session Title: Cataract Surgery & Retinal Complications

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 17:34

Venue: Room A3, Podium 1

First Author: : E.Gelman ISRAEL

Co Author(s): :    J. Hanhart   Y. Weill   A. Abulafia   D. Smadja   D. Teren   D. Zadok     

Abstract Details

Purpose:

Cataract surgery has made major advances in the past decades, resulting in higher visual outcomes. Consequently patient’s expectations are continuously rising. Currently, dilated clinical fundus examination is the standard of care for preoperative evaluation of the macula. However, preoperative identification of macular diseases, particularly in the presence of media opacities, remains a challenge for ophthalmologists. In this pilot study, we aim to assess the efficacy of spectral-domain optical coherence tomography (SD-OCT) as a strategy for identifying macular disease in patients scheduled for cataract surgery.

Setting:

Dedicated clinic of cataract preoperative assesment and retina unit equiped with SD-OCT, Shaare Zedek Medical Center affiliated with the Hebrew university of Jerusalem

Methods:

Preoperative Heidelberg Spectralis SD-OCT (Heidelberg Engineering, Heidelberg, Germany) scans were performed on 101 consecutive patients scheduled to have routine cataract surgery in our institution. Scans were reviewed by a retinal specialist for detection of macular pathology.

Results:

101eyes from 101 patients (53 females, age: 72.0 ± 11.6 years) werereviewed. 56 referred from practices outside our medical center. 7 OCT scans were non interpretable due to advanced cataract. 53 (52.5%) were found to have single or several macular pathologies. Pathologies included AMD (N=25), CME (N=8), ERM (N=14), high myopic changes (N=8), macular hole (N=3) and central serous chorioretinopathy (N=1). OCT revealed previously unnoticed pathology in 35 patients. The management of 4 patients was changed due to OCT detected pathology. Clinically overlooked pathology rate was 75.9% in patients extra-institutionnally referred and 52.0% in patients referred from our clinics (p=0.20).

Conclusions:

SD-OCT examination is a useful preoperative modality for detecting macular pathology in patients scheduled for routine cataract extraction surgery. This noninvasive widely available technique may become part of standard preoperative care as it enables better matching of expectations and sometimes modify the management.

Financial Disclosure:

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