Pre-operative optical coherence tomography macula: An indispensable investigation to predict post-operative outcomes

Ophthalmology has grown to greater heights with newer technologies and the goal to provide vision to the ones who had lost it or on verge of loosing it. Cataract being leading cause of blindness is now easier as the surgery has been revolutionised with the introduction of phacoemulsification, femtosecond laser-assisted cataract surgery, correction of corneal astigmatism and the use of premium intraocular lenses to get the best post-operative visual outcomes, however in all of this pre and post operative risks still persist.

This study that I am talking about today was performed at Department of Ophthalmology, Government Medical College, Surat, Gujarat, India, where 200 cataract patients went through pre-operative examinations to understand and utilize the efficacy of the technique Spectral Domain Optical Coherence Tomography scan (SD-OCT) to yield more favourable post operative cataract surgeries and avoiding unforeseen complications.

While undergoing Optical Coherence Tomography examination, 65 (20.96%) eyes out of 310 showed abnormalities. The most common presentation was epiretinal membrane in 22 eyes (7.09%) followed by pigment epithelial detachment in 14 (4.5%) eyes. Other findings were drusen (nine eyes), lamellar macular hole (five), vitreomacular traction (five), IS-OS junction abnormalities (four), retinal pigment epithelium alterations (two), juxtafoveal telangiectasia (one), foveal thinning (one), pseudovitelliform lesion (one) and spongy oedema (one).

The various findings that were obtained provided us an insight into the appropriate choice of intraocular lenses, required surgical consents and the therapeutic strategy for each individual patient.

Thus, the robust study concluded that Spectral Domain Optical Coherence Tomography scan macula is an indispensable investigation before cataract extraction to avoid unsolicited post-operative surprises and medicolegal conundrums.

Such a study, should encourage practicing Opthalmologists and specially Cataract surgeons to consider using the pre- operative procedure, as it comes out to be is of paramount importance to identify occult macular pathologies, and ensure positive post-operative visual outcomes and avoid post-operative complications.

Reference:

Solu TM, Balraj S, Patel I, Acharya S. Pre-operative optical coherence tomography macula: An indispensable investigation to predict post-operative outcomes. Glob J Cataract Surg Res Ophthalmol 2022;1:59-63.