Microscope Mounted AS-OCT for Posterior Polar Cataracts

Tuesday, April 21, 2015: 11:06 AM
Room 1B (San Diego Convention Center)
Somshekar Nagappa, MD
Mathew K. Kummelil, MD
Sudeep Das, MD, DNB
Rohit Shetty, DNB, FRCS

To demonstrate the intraoperative use of in-vivo microscope mounted optical coherence tomography (AS-OCT) for the assessment of pre-existing posterior capsular defect in patients with posterior polar cataracts (PPC).

Three patients were assessed using intraoperative microscope mounted AS –OCT for posterior capsular continuity and potential space between the capsule and posterior pole of the cataract prior to commencing surgery. One of these patients underwent a femtolaser cataract surgery during which the HD-OCT of the femtolaser was used for imaging the PPC. After initial examination, the surgeon proceeded with phacoemulsification with lens implantation using standard surgical techniques.

While the HD-OCT of the femtolaser could not detect any space between the cataract and the posterior capsule, the intraoperative microscope mounted OCT did detect this space. In other patient posterior capsular continuity with potential space between the posterior pole of the cataract and the posterior capsule was detected. The surgeon proceeded with standard phacoemulsification with hydrodissection and there was no posterior capsular rupture, the third case were the intraoperative OCT did not detect a space PPC with hydrodelineation and rotation-less phacoemulsification was performed. However, there was no PCR even in this case.

Intraoperative microscope mounted ASOCT can be a useful tool to assess status of the posterior capsule in cases of posterior polar cataract.