期刊
JOURNAL OF CATARACT AND REFRACTIVE SURGERY
卷 47, 期 1, 页码 78-82出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.jcrs.0000000000000389
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This study assessed the clinical relevance of routine preoperative SD-OCT scanning for identifying macular pathologies in patients scheduled for cataract surgery. The results showed that routine SD-OCT scans can help identify macular pathologies that might be missed or underestimated by standard fundus bio-microscopic examination, potentially improving patient management.
Purpose: To assess the clinical relevance of routine preoperative spectral-domain optical coherence tomography (SD-OCT) for identifying macular pathologies in patients scheduled for cataract surgery. Setting: Shaare-Zedek Medical Center, Jerusalem, Israel. Design: Retrospective case series. Methods: Consecutive patients, 50 years of age and older, scheduled for standard cataract extraction surgery were enrolled from November 2017 to January 2018. All study patients underwent routine SD-OCT scanning before cataract surgery. The scans were reviewed by a retinal specialist for macular pathology and compared with preoperative fundus biomicroscopic examination findings. The incidence of macular pathologies and changes in patient management as a result of the macular SD-OCT findings were assessed. Results: Four hundred fifty-three eyes of 453 patients were enrolled in the study; 42 eyes (9.2%) were excluded because of noninterpretable SD-OCT scans attributable to advanced cataract, leaving scans of 411 eyes of 411 patients for study inclusion. Macular pathologies were detected by SD-OCT in 167 eyes (40.6%), including age-related macular degeneration (50%), epiretinal membrane (28.3%), and cystoid macular edema (12.8%). Overall, the management of 107 patients (26.0%) was modified because of macular SD-OCT findings, which were either missed (22.8%) or underestimated (3.2%) by the fundus biomicroscopic examination. Changes in preoperative patient management included altering patient consultation regarding presbyopia correction solutions (73 eyes [17.8%]) and referral to a retinal specialist for consultation (34 eyes [8.3%]). Conclusions: Routine macular SD-OCT scans for cataract surgery candidates helped to identify macular pathologies that might be missed or underestimated by standard fundus bio-microscopic examination. The added information could improve patient management. Copyright (C) 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS
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