Purpose To develop and evaluate a cataract quantification method using a swept-source optical coherence tomography (SS-OCT) device (IOLMaster 700). Setting Hanusch Hospital, Vienna, Austria. Design Prospective multicenter case series. Methods This study included patients with cataract in at least 1 eye. Two independent examiners performed Lens Opacities Classification System II (LOCS II) grading at the slitlamp independently. Corrected distance visual acuity, contrast sensitivity, and SS-OCT measurements were also performed. In addition, the phacoemulsification energy and time were recorded. To develop an objective SS-OCT-based cataract quantification system, all SS-OCT scans were segmented and the local pixel intensity unit of the lens ...

Purpose To determine the anatomic criteria for diagnosing keratoconus progression by corneal optical coherence tomography (OCT). Setting Quinze-Vingts National Ophthalmology Hospital, Paris, France. Design Prospective case series Methods Scanning-slit corneal topography (Orbscan II) and Fourier-domain corneal OCT (RTVue) were performed in eyes with mild to moderate keratoconus (progressive or nonprogressive [stable] ectasia) at each examination to assess the keratoconus. Disease progression was defined as an increase of at least 1.0 diopter (D) in the steepest keratometry (K) measurement over 6 months. Results Of the 134 eyes of 134 patients with mild to moderate keratoconus, 98 had had progressive ectasia ...

Purpose To evaluate the accuracy of a swept-source optical coherence tomography (SS-OCT) biometer compared with a standard partial coherence interferometry (PCI) biometer in terms of phacovitrectomy for vitreomacular pathology and cataract. Setting Department of Ophthalmology, Ludwig-Maximilians-University Munich, Germany. Design Prospective, nonrandomized, single center consecutive case series. Methods Patients with age-related cataract, regular corneal astigmatism less than 1.25 diopters (D) and a clinically significant vitreomacular pathology (epiretinal membrane [ERM], macular hole, or vitreomacular traction [VMT] syndrome) who had combined phacovitrectomy with internal limiting membrane peeling were enrolled. Objective and manifest refraction, corrected distance visual acuity, SS-OCT biometry, and PCI biometry ...

Purpose To evaluate crystalline lens and intraocular lens (IOL) tilt using a swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700). Setting Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. Design Retrospective case series. Methods The study patients were evaluated for 1) repeatability of the crystalline lens tilt measurement, 2) preoperative crystalline lens and postoperative IOL tilt in right eyes, 3) mirror symmetry between right eyes and left eyes, 4) the correlation between preoperative crystalline lens and postoperative IOL tilt, and 5) the correlation between the magnitude of lens tilt and ocular parameters. Results The study comprised 333 patients ...

Purpose To characterize the effect of incision size on corneal incision repair and remodeling over 3 months after cataract surgery. Setting Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand. Design Prospective case series. Methods Eyes having routine cataract surgery were randomized to receive 2.20 mm or 2.85 mm uniplanar clear corneal incisions. Anterior segment optical coherence tomography of incision thickness, length, width, gaping, and angle and specular microscopy of endothelial cell density (ECD), polymegathism, and pleomorphism were completed at baseline and 1, 7, 30, and 90 days postoperatively. Results Each incision group comprised 50 eyes (50 ...

Zhao et al. 1 describe changes in retinal vessel density and foveal avascular zone area after routine cataract surgery. These parameters were evaluated using optical coherence tomography (OCT) angiography, an exciting new imaging technology for noninvasive evaluation of the retinal microvasculature. 2 It has been reported that the foveal avascular zone, both in the superficial and deep retinal capillary plexus, varies significantly in size, even in normal healthy adults. 3

We read with interest the article by Abdelmassih et al.1 regarding the role and cost-effectiveness of preoperative spectral-domain optical coherence tomography (SD-OCT) in patients having cataract surgery. In their study, the macular SD-OCT was abnormal in 26.7% of eyes overall and in 17.5% of eyes when only anomalies not seen on fundus examination were taken into consideration.1 These results are somewhat different from those in previous studies reporting only pathological macular findings in patients having routine cataract surgery.

Purpose To determine whether preoperative assessment of posterior capsule integrity using anterior segment optical coherence tomography (AS-OCT) can predict posterior capsule dehiscence in patients with posterior polar cataract having phacoemulsification. Setting Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India. Design Prospective observational study. Methods Patients with posterior polar cataract who had phacoemulsification between October 2012 and November 2013 were included in the study. Preoperative AS-OCT imaging was performed to assess the integrity of the posterior capsule. Anterior segment OCT images of the posterior capsule were graded as “intact” or “dehiscent.” Phacoemulsification was performed by the same surgeon who ...

Purpose To evaluate intraoperative anterior chamber depth (ACD) measurements of the aphakic eye to predict the postoperative ACD and compare 2 intraocular lens (IOL) designs. Setting Hanusch Hospital, Vienna, Austria. Design Prospective study. Methods In this prospective study, patients scheduled for cataract surgery received a plate-haptic IOL (Asphina, Carl Zeiss Meditec AG) or an open-loop haptic IOL (ZCB00, Johnson & Johnson). Preoperatively, optical biometry (IOLMaster 700, CZM, or Lenstar, Haag-Streit) was performed. Intraoperatively, a prototype setup was used to perform time-domain OCT scans of the anterior eye segment (Visante connected to OPMI Lumera 200, both CZM). The intraoperative ACD was measured ...

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 ...

Purpose To use optical coherence tomography (OCT) angiography and a split-spectrum amplitude–decorrelation angiography algorithm to evaluate the changes in the macular vascular system after uncomplicated phacoemulsification. Setting Department of Ophthalmology, Eye and and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China. Design Prospective case series. Methods Patients with senile cataracts were included. Retinal vessel density and thickness at the macular area were checked by OCT at baseline and at 1 week, 1 month, and 3 months after cataract surgery. Results Thirty-two eyes (32 patients) were included in the final analysis. There was a significant increase in retinal ...

Purpose To use anterior segment optical coherence tomography (AS-OCT) to compare corneal stromal demarcation line depth after 4 treatment protocols of corneal crosslinking (CXL). Setting Eye Clinic, Sapienza University of Rome, Terracina (Latina), Italy. Design Prospective case series. Methods Patients with progressive keratoconus were delegated to one of the following CXL treatments: (1) conventional epithelium (epi)-off 3 mW/cm 2 according to the standard Dresden protocol (C-CXL group), (2) accelerated epi-off 10 mW/cm 2 (A-CXL group), (3) transepithelial epi-on 3 mW/cm 2 (TE-CXL group), or (4) transepithelial epi-on by iontophoresis 10 mW/cm 2 (I-CXL group). Two ...

Purpose To assess a new objective cataract grading method based on lens densitometry on swept-source optical coherence tomography (SS-OCT) scans provided by the IOLMaster 700. Settings Rothschild Foundation, Paris, France. Design Prospective case series. Methods All patients consulting for cataract evaluation who provided their consent to participate in the study were included. A history of eye surgery, corneal or retinal disorders, and ocular dryness were exclusion criteria. The average lens densitometry was measured with SS-OCT scans using ImageJ software. The ocular scatter index (OSI) measured with a double-pass aberrometer (Optical Quality Analysis System), the Pentacam nucleus staging (hereafter referred to ...

We describe the surgical technique of microscope-integrated intraoperative optical coherence tomography (OCT)-guided small-incision lenticule extraction. The technique enables manual tracking of surgical instruments and identification of the desired dissection plane. It also helps discern the relation between the dissector and the intrastromal lenticule. The dissection plane becomes hyperreflective on dissection, ensuring complete separation of the intrastromal lenticule from the overlying and underlying stroma. Inadvertent posterior plane entry, cap–lenticule adhesion, incomplete separation of the lenticule, creation of a false plane, and lenticule remnants may be recognized intraoperatively so corrective steps can be taken immediately. In cases with a hazy ...

Laser refractive surgery has increased markedly in recent years, making the detection of corneal abnormalities extremely relevant. For this reason, an accurate diagnosis of clinical or subclinical keratoconus is critical. Corneal topography is the primary diagnostic tool for keratoconus detection, and pachymetry data and corneal aberrations are also commonly used. Recently, tomographic measurements using optical coherence tomography and corneal biomechanical indices have been used. In incipient and subclinical keratoconus, the use of a single parameter as a diagnostic factor is not sufficiently accurate. In these cases, the use of algorithms and predictive models is necessary. In addition, determining whether the ...

Purpose To define the incidence of cystoid macular edema (CME) and spectral-domain optical coherence tomography–detectable (SD-OCT) subclinical changes in central retinal thickness in patients using prostaglandin analog (PGA) eyedrops after phacoemulsification. Setting Manchester Royal Eye Hospital, Manchester, United Kingdom. Design Prospective case series. Methods A consecutive analysis of the incidence of postoperative CME after phacoemulsification by a single surgeon was performed in eyes of patients using PGA eyedrops between March 2010 and January 2014. The presence of CME was determined using SD-OCT (Cirrus) 3 weeks and 6 weeks postoperatively. Exclusion criteria included preexisting pathology known to predispose to CME ...

We describe the use of a simple tool to evaluate the postoperative alignment of toric intraocular lenses (IOLs). The entire anterior segment is scanned using anterior segment optical coherence tomography and analyzed with an internal dedicated tool. A topographic map is displayed along with an anterior segment image, including a linear axis marker centered on the corneal apex. The marker can be rotated until it is aligned with the line connecting the IOL marking dots, precisely reproducing the IOL astigmatic axis, which is measured in angle degrees. The value of the IOL astigmatic axis is compared with the value of ...

Purpose To compare crystalline lens tilt in eyes before and intraocular lens (IOL) tilt in eyes after cataract surgery using swept-source optical coherence tomography (SS-OCT) (IOLMaster 700). Setting Hanusch Hospital, Vienna, Austria. Design Prospective case series. Methods Patients' eyes were scanned 1 week before and 2 months after cataract surgery with IOL implantation using an SS-OCT device. This device performs B-scans along 6 meridians (0, 30, 60, 90, 120, and 150 degrees) to determine lens and IOL tilt. Results Sixty-two eyes (62 patients) were included in the analysis. The mean magnitude and direction of tilt showed mirror symmetry between both ...

Purpose To distinguish between corneal ectasia and contact lens–related warpage by characteristic patterns on corneal topography and optical coherence tomography (OCT) epithelial thickness maps. Setting Casey Eye Institute, Portland, Oregon, USA. Design Prospective and retrospective case series. Methods Axial and mean power maps were obtained on corneal topography systems. Epithelial thickness maps were generated using RTVue OCT. A sector divider was applied to all maps. The locations of the minimum epithelial thickness, maximum epithelial thickness, maximum axial power, and maximum mean power were determined based on sector averages. Agreement was defined as the extremums occurring in the same or ...

Purpose To compare axial length (AL) measurements between a swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700) and a partial coherence interferometry (PCI) biometer (IOLMaster, version 5.4) in myopic eyes. Setting Severance Hospital, Yonsei University, Seoul, South Korea. Design Prospective evaluation of a diagnostic test. Methods This study enrolled patients with a diagnosis of myopia in their medical records. Two consecutive AL measurements were performed in each eye in random order using the 2 biometers. Subanalysis was performed according to lens status, fixation status, degree of myopia, and the presence of posterior staphyloma. The interdevice agreement was evaluated with ...

Purpose To determine the incremental benefit of swept-source optical coherence tomography (SS-OCT) in identifying occult macular disease preoperatively in patients scheduled for routine cataract surgery. Setting Shahzad Eye Hospital, Karachi, Pakistan. Design Prospective case series. Methods Preoperative SS-OCT scans were performed in all patients scheduled to have cataract surgery between January and March 2016. Scans were subsequently reviewed for the presence of macular abnormalities. Patients with clinically detectable retinal pathologies were excluded. Results Of the 179 eligible patients, 155 were included in the study. Macular pathology was noted in 17 patients (10.9%). The most commonly identified conditions were age-related ...

We read with interest the article by Hirnschall et al. 1 reporting that the central 1.0 mm retinal scan obtained using a biometry device (IOLMaster 700, Carl Zeiss Meditec AG) with swept-source optical coherence tomography (SS-OCT) technology provided useful information on the status of the macula, although it could not replace a macular scan using a dedicated spectral-domain OCT (SD-OCT) device.

Purpose To assess the position of intraocular lenses (IOLs) at the end of standard phacoemulsification with intraoperative spectral-domain optical coherence tomography (SD-OCT). Settings Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria. Design Prospective case series. Methods Standard phacoemulsification with IOL implantation was performed. The Rescan 700 SD-OCT system was used for intraoperative imaging. The anterior segment of the eye was scanned using SD-OCT at the end of the surgery. The distance from the IOL optic center and the IOL optic edge to the posterior capsule was measured postoperatively using graphic software. Results The study comprised 74 patients (101 eyes). The ...

Purpose To evaluate spectral-domain optical coherence tomography (SD-OCT) as a strategy for identifying occult macular disease preoperatively in patients scheduled for cataract surgery with implantation of an advanced-technology intraocular lens (IOL). Setting Private practice, Danbury, Connecticut, USA. Design Retrospective consecutive case series. Methods Macular SD-OCT scans were performed on all patients scheduled for cataract surgery and Restor multifocal or toric IOL implantation over a 6-month period. All scans were reviewed for abnormalities of the retina, retinal pigment epithelium, or vitreomacular interface. For subgroup analysis, the following health information was collected: age, sex, smoking history, hypertension, heart disease, hyperlipidemia or hypercholesterolemia ...