J.ophthalmol.(Ukraine).2022;6:3-9.
http://doi.org/10.31288/oftalmolzh2022639
Received: 25.08.2022; Accepted: 21.11.2022; Published on-line: 21.12.2022
Value of morphological OCT changes in the posterior lens capsule in optimization of surgical treatment for posterior capsular cataracts
N. S. Lutsenko 1, 2, O. A. Isakova 1, 2, O. A. Rudycheva 1, 2, T. S. Kyrylova 1, 2, G. V. Iatsun 2
1 State Institution “Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine”
2 Zaporizhzhia Regional Clinical Hospital
Zaporizhzhia (Ukraine)
TO CITE THIS ARTICLE: Lutsenko NS, Isakova OA, Rudycheva OA, Kyrylova TS, Iatsun GV. Value of morphological OCT changes in the posterior lens capsule in optimization of surgical treatment for posterior capsular cataracts. J.ophthalmol.(Ukraine).2022;6:3-9. http://doi.org/10.31288/oftalmolzh2022639
Background: It is reasonable and important to optimize the diagnostic and surgical measures for faster visual rehabilitation of patients with posterior capsular cataract (PCC).
Purpose: To investigate morphological changes (as assessed by optical coherence tomography (OCT)) in the posterior lens capsule (PLC) in PCC, and to assess their value in the optimization of phacoemulsification for these cataracts.
Material and Methods: Of the 1780 eyes (1200 patients) with cataract examined, 512 eyes (28.8%) were diagnosed with PCC. Patients had OCT of the anterior segment (AS-OCT) and phacoemulsification. The morphological changes in the PLC as assessed by OCT, the course of surgical treatment and perioperative complications were reviewed.
Results: Three types of morphological changes in the PLC were identified. Type 1 changes were characterized by a clear PLC margin and found in 312 of the 512 eyes (61%). A posterior capsule-sparing phacoemulsification (i.e., with low power, vacuum and irrigation settings) was used only in 28% of eyes. In type 2 changes, the PLC margin was not uniform in reflectivity and thickness, but appeared clear at the retrolenticular space. Type 2 changes were found in 185 of the 512 eyes (36%). We refrained from hydrodissection in 95.1% of cases, used a posterior capsule-sparing phacoemulsification in 97% of cases and posterior capsule polishing in all cases of PLC with type 2 changes. Type 3 changes were characterized by PLC bulging into the retrolenticular space, and were found in 15 eyes (3%). A capsule rupture was observed in 53% of eyes with type 3 changes, although we used a posterior capsule-sparing phacoemulsification with viscodilation in these cases.
Conclusion: AS-OCT allows detailed assessment of morphological changes in the PLC and identification of three types of these changes. It is reasonable to take in account these facts when selecting a surgical treatment strategy.
Keywords: posterior capsular cataract, optical coherence tomography
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Disclosures
Corresponding Author: Rudycheva O. A., e-mail: rudychevaolga5@gmail.com
Author Contributions: Lutsenko NS: Conceptualization, Supervision, Investigation, Data Analysis and Interpretation, Writing – original draft, Writing – review & editing; Isakova OA: Investigation, Data Analysis and Interpretation, Formal Analysis, Writing – original draft, Writing – review & editing; Rudycheva OA: Methodology, Investigation, Data Analysis and Interpretation, Writing – review & editing; Kyrylova TS: Methodology, Investigation, Data Analysis and Interpretation, Writing – review & editing; Iatsun GV: Resources, Investigation, Writing – review & editing. All authors reviewed the results and approved the final version of the manuscript.
Disclaimer: The opinions presented in this article are those of the authors and do not necessarily represent those of their institutions.
This paper is a part of the research program entitled Optimization of Eye Disease Diagnosis, Treatment and Follow-up with Ocular Coherence Tomography and Angiography (registration number № 0119U101932).
Conflict of Interest Statement. The authors state that they have no conflict of interest that might bias this work.
Ethical Statement: This study included human participants, was approved by the local bioethics committee and adhered to the tenets of the Declaration of Helsinki. Appropriate informed consent was obtained. This study did not include animal experiments.
Abbreviations: AS-OCT, anterior segment optical coherence tomography; PCC, posterior capsular cataract; BCVA, best-corrected visual acuity; OCT, optical coherence tomography; Phaco, phacoemulsification of cataract.