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Intraoperative spectral-domain OCT provides reliable imaging of IOL position
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Intraoperative spectral-domain OCT was successful in imaging IOL position during standard phacoemulsification, a study found.
The prospective study included 101 eyes of 74 patients who underwent standard phacoemulsification and IOL implantation.
An AcrySof IQ SN60WF IOL (Alcon) was implanted in 59 eyes (58.4%) and a Tecnis IOL (Abbott Medical Optics) in 42 eyes (41.6%). Standard phacoemulsification was performed alone in 88 eyes (87.1%) and combined with pars plana vitrectomy in 13 eyes (12.9%).
SD-OCT was used at the end of surgery to scan the anterior segment of the eye. Graphic software was used postoperatively to measure distance from the IOL optic center and the IOL optic edge to the posterior capsule, according to the study.
Imaging results showed no contact between the IOL central optic and posterior capsule in 88 eyes (87.13%), partial contact in 11 eyes (10.89%) and full contact in two eyes (1.98%). Partial contact between the IOL edges and posterior capsule was observed in 42 cases.
Mean distance between the IOL central optic and posterior capsule was 0.71 pixel in 99 cases. Mean distance between the IOL edge and posterior capsule was 0.21 pixel.
Mean axial length was 23.65 mm in cases with no contact between the IOL central optic and posterior capsule and 24 mm in cases with full or partial contact.
“Intraoperative SD-OCT facilitated the visualization of the IOL position because it obtained substantial hyperreflectivity from the IOL, the capsular bag and the anterior vitreous,” the study authors said. “Contact between the IOL central optic and central posterior capsule was rare, probably because the volume of the lens capsule is larger than volume of the IOL.” – by Matt Hasson
Disclosure: Lytvynchuk reports no relevant financial disclosures. See the full study for all other authors’ relevant financial disclosures.
Perspective
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John A. Hovanesian, MD, FACS
How can we do better than intraoperative aberrometry? How about knowing exactly the lens implant position inside the capsular bag, taking all guesswork out of the effective lens position question? This article highlights a novel use of OCT to do just that during surgery. It will also open the way for new lens implant designs, in which a haptic system designed to hold interchangeable optics of different powers can be implanted into the eye for measurement, then allowing placement of an optic in that known position.
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Lytvynchuk LM, et al. J Cataract Refract Surg. 2016;doi:10.1016/j.jcrs.2016.01.044.
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