Anterior segment imaging makes complicated cataract cases ‘almost routine,’ surgeon says

SÃO PAULO, Brazil — Anterior segment imaging technologies can help reduce the risk of complications in challenging cataract surgery cases, such as intumescent cataracts, according to a speaker here.

Virgílio Centurion, MD, said anterior segment imaging has turned once-daunting conditions into “almost routine” surgical cases. He described his experience with the Oculus Pentacam imaging system at a symposium of the Latin American Society of Cataract and Refractive Surgeons held here during the World Ophthalmology Congress.

“In difficult and challenging cases, we want the surgery to become more predictable,” Dr. Centurion said.

To help accomplish this, he said, the Pentacam employs a rotating Scheimpflug camera to create three-dimensional views of the anterior segment.

He said new imaging technology makes it possible to distinguish between a cataract that is intumescent and one that is merely white. The Pentacam images reveal the depth of the anterior chamber as well as the thickness of the crystalline lens, both factors that can help determine if the cataract is intumescent, he said.

“The most important thing is to have a diagnosis that is certain,” Dr. Centurion said. With this, the surgeon can create a protocol tailored specifically to the pathology at hand.

For intumescent cataracts, Dr. Centurion said, his surgical approach includes dyeing the capsule, applying a dispersive viscoelastic, and aspirating the cataract immediately upon needling the capsule.

He said the Pentacam gives surgeons a correct diagnosis, enabling them to adopt “a strategy suited to avoid problems with the capsulotomy.”