Preoperative spectral-domain optical coherence tomography in patients having cataract surgery.

PURPOSE

To evaluate the role and cost-effectiveness of preoperative spectral-domain optical coherence tomography (SD-OCT) in patients having cataract surgery.

SETTING

Fondation Opthalmologique Adolphe de Rothschild, Paris, France.

DESIGN

Retrospective case series.

METHODS

All patients who had cataract surgery had macular and retinal nerve fiber layer SD-OCT preoperatively. A complete ophthalmologic examination was performed, including corrected near (CNVA) and corrected distance visual acuities, intraocular pressure (IOP), and a fundus examination.

RESULTS

The study comprised 245 patients (401 eyes) with a mean age of 73.5 years ± 9.81 and a mean IOP of 15.6 ± 3.04 mm Hg. Of 107 eyes (26.7%) with abnormal macular SD-OCT, 70 eyes were judged normal on fundus examination. The most frequent anomalies were age-related macular degeneration and epiretinal membrane. Age over 70 years and CNVA worse than Parinaud 2 were associated with higher rate of abnormal macular SD-OCT (odds ratio, 2.76 and 2.28, respectively). Fifty-seven eyes (14.2%) had abnormal retinal nerve fiber layer SD-OCT, 30% of them with no history of glaucoma and no detected anomaly on fundus examination. Age over 70 years and a history of glaucoma were associated with a higher rate of retinal nerve fiber layer anomalies.

CONCLUSIONS

Preoperative SD-OCT scanning was significantly more effective in detecting anomalies in patients having cataract surgery than fundus examination. Older age and CNVA worse than Parinaud 2 were associated with higher rates of abnormal macular SD-OCT. Older age and a history of glaucoma were associated with higher abnormal retinal nerve fiber layer anomaly rates.