OCT Screening Before Cataract Surgery Can Improve Outcomes

by: Laird Harrison

CHICAGO — The routine use of optical coherence tomography (OCT) to screen candidates for cataract surgery can improve surgery timing and planning, give patients realistic expectations, and even lead to changes in treatment plans, results from a new study show.

“There is no reason not to do this,” said Yishay Weill, MD, from the Shaare Zedek Medical Center in Jerusalem, Israel.

OCT, a relatively new technology, is noninvasive and fast and is becoming standard equipment for cataract surgeons. But it is not used routinely before cataract surgery everywhere. “Israel is pretty unique in screening all our patients,” Weill told Medscape Medical News.

Fundus photography is the standard of care for preoperative evaluation, but it is limited by opaque media and poor pupil dilation, he explained here at the American Academy of Ophthalmology (AAO) 2018 Annual Meeting.

Overlooked pathologies can lead to suboptimal postoperative results, such as unexpected low visual acuity and worsening of the underlying baseline macular pathology.

For their study, Weill and his colleagues assessed 226 patients who underwent screening with OCT at Shaare Zedek in November and December 2017. The mean age of the patients was 73.2 years, the mean interval from referral to preoperative evaluation was 59 days, and 57% of the patients were women.

OCT images showed normal retinas in 50.9% of the eyes and abnormalities in 40.3%; 8.8% of the images were not interpretable.

The team categorized the macular pathologies. There were 43 eyes with aged-related macular degeneration, 27 with epiretinal membrane, 18 with cystoid macular edema, six with vitreomacular traction, four with lamellar defects, and four with some other pathology.

Source: Medscape https://www.medscape.com/viewarticle/904295