Title: Posterior Segment Changes Following Uncomplicated Cataract Surgery-A Study with B-Scan and OCT
Authors: Jayasree P Venugopal, Mallika O U, Rajini K C
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.95
Abstract
Purpose: To assess the posterior segment changes following uncomplicated cataract surgery-SICS using ultrasound B-scan and optical coherence tomography.
Materials and Methods: In a prospective study, 50 patients who underwent an uncomplicated small incision cataract surgery were analysed with ultrasonography (USG) and optical coherence tomography (OCT) preoperatively, and post operatively at 1 week, 1 month, and 3 months. Mean, standard deviation and Chi-square test were the statistical methods used.
Results: The mean age of subjects were 65.50 +/- 10.2 years, 62% (31) were female (62%) and 38% (19) were male. Preoperatively, 46 patients (92%) had normal USG, 4 (8%) had incomplete posterior vitreous detachment (PVD) and the central foveal thickness was found to be 147.80+/- 17.182 micro meters. Post-operatively, incidence of PVD at 3 months was 34%. PVD was noted more in those above 65 years of age than those below (50.0% vs 16.7%, p<0.05). 3 patients (6%) had macular edema, of which 1 (2%) had cystoid macular edema. The event of having macular edema was more likely in diabetic (22.2%) than non-diabetic patients (2.4%). The p value < 0.05 by chi square test; indicates that there was a statistically significant correlation between presence of macular edema and reduction in visual acuity.
Conclusions: Ultrasonography and optical coherence tomography are non-invasive and efficient tools for assessment of posterior segment of the eye. Ultra sound B-scan effectively detects posterior vitreous detachment. Incidence of pseudophakic posterior vitreous detachment increase with age. Optical coherence tomography aids in the early detection, diagnosis and follow up of cystoid macular edema. Diabetes mellitus appears to predispose a patient to post-operative macular edema and cystoid macular edema seems to be an important cause of reduced visual acuity after uncomplicated cataract surgery.
Keywords: SICS, central foveal thickness, macular edema, posterior vitreous detachment.
References
1. Vision 2020 action plan 2006-2010.WHO
2. Bello TO, AdeotiCO.et al. Ultrasonic assess-ment in pre-operative cataract patients. Niger Postgrad Med J. 2006 Dec;13(4):326-8.
3. Jack J Kanski; Clinical Ophthalmology 6th edition p-698-699.
4. Jaffe GJ, CaprioliJ.et al. Optical coherence tomography to detect and manage retinal disease and glaucoma. Duke Eye Center, Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina 27710, USA.
5. Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science. 1991;254:1178–1181.
6. Figurska M, Robaszkiewicz J, Wierzbowska J et al. Optical coherence tomography in imaging of macular diseases. Am J Ophthalmol. 2004 Jan;137(1):156-69.
7. Pedut-Kloizman T, Paktera HM, Schuman JS, Szwartz JC, HeeMR.et al. OphthalClin North Am 1998;11:465-87.
8. Massin P, Vicaut E, Haouchine B, Erginay A, Paques M, GaudricA.et al. Reproducibility of retinal mapping using optical coherence tomography. Arch Ophthalmol 2001;119:1135-42.
9. Schuman J, Pedut-Kloizman T, Hertzmark E, Hee MR, Wilkins JR, Coker JG, et al. Reproducibility of nerve fiber layer thickness measurement using optical coherence tomography. Ophthalmology 1996;103:1889-98.
10. Muscat S, Parks S, Kemp E, Keating D.et al. Repeatability and reproducibility of macular thickness measurements with Humphrey OCT system. Invest Ophthalmol Vis Sci 2002;43:490-95.
11. Koozekanani D, Roberts C, Katz SE, HerderickEE.et al. Intersession repeatability of macular thickness measurements with the Humphrey 2000 OCT. Invest Ophthalmol Vis Sci 2000;41:1486-91.
12. Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Rutledge B, et al. Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol1995; 113:1019-29.
13. Kozak I, Morrison VL, Clark TM, et al. Discrepancy between fluorescein angiogr-aphy and optical coherence tomography in detection of macular disease. Retina. 2008;28(4):538–544.