Patient management modifications in cataract surgery candidates following incorporation of routine preoperative macular optical coherence tomography.
Journal
Journal of cataract and refractive surgery
ISSN: 1873-4502
Titre abrégé: J Cataract Refract Surg
Pays: United States
ID NLM: 8604171
Informations de publication
Date de publication:
01 Jan 2021
01 Jan 2021
Historique:
received:
04
05
2020
accepted:
26
07
2020
pubmed:
21
8
2020
medline:
29
7
2021
entrez:
21
8
2020
Statut:
ppublish
Résumé
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. Shaare-Zedek Medical Center, Jerusalem, Israel. Retrospective case series. 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. 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%]). Routine macular SD-OCT scans for cataract surgery candidates helped to identify macular pathologies that might be missed or underestimated by standard fundus biomicroscopic examination. The added information could improve patient management.
Identifiants
pubmed: 32815862
pii: 02158034-202101000-00011
doi: 10.1097/j.jcrs.0000000000000389
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
78-82Informations de copyright
Copyright © 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.
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