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 ...

Purpose To assess the repeatability of a new swept-source optical coherence tomography (SS-OCT) biometer (IOLMaster 700) and evaluate the agreement with an optical low-coherence reflectometry (OLCR) biometer (Lenstar 900) in cataractous eyes. Setting Tertiary eyecare facility. Design Prospective evaluation of a diagnostic test. Methods Eyes of patients had 3 consecutive scans acquired by the same operator. The repeatability of measurements was assessed using the within-subject standard deviation and coefficient of variation (CoV). Agreement between the mean measurements of each machine was evaluated. Results The study comprised 100 eyes of 100 patients. The median lens thickness and axial length (AL) measurements ...

Purpose To assess the sensitivity and specificity for detecting macular disease with a new optical biometry device with swept-source optical coherence tomography (SS-OCT) used before cataract surgery. Setting Hanusch Hospital, Vienna, Austria. Design Consecutive case series. Methods This study included patients with or without macular disease. All patients were scanned using the new biometry device (IOLMaster 700), which allows a 1.0 mm central retinal scan using SS-OCT technology. Also, all eyes were assessed using a dedicated retinal OCT device (RTVue) on the same day. Two experienced examiners and 1 ophthalmology resident graded all scans individually. Sensitivity and specificity for ...

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 ...

Capsular block syndrome (CBS) is a recognized complication after cataract surgery. It is caused by fluid accumulation in a closed chamber inside the capsular bag due to the nucleus or intraocular lens (IOL) optic occluding the capsule opening created by the continuous curvilinear capsulorhexis.1,2 We present a case of CBS following penetrating keratoplasty (PKP) with cataract extraction and IOL implantation (triple procedure) that was diagnosed using anterior segment optical coherence tomography (AS-OCT).

Purpose To evaluate the repeatability and reproducibility of the measurements obtained with the Argos, a new biometer with swept-source optical coherence tomography (SS-OCT), and to compare them with the results obtained with the IOLMaster 500 (partial-coherence interferometry [PCI]) and the Lenstar LS 900 (optical low-coherence reflectometry [OLCR]) biometers. Setting Private practice, Lynwood, California, USA. Design Prospective observational study. Methods All measurements were performed with the SS-OCT tomographer, the PCI biometer, and the OLCR biometer. Results Eyes (n = 107) were measured to evaluate the axial length (AL), central corneal thickness (CCT), aqueous depth, anterior chamber depth (ACD), lens thickness, pupil size ...

Purpose To estimate the repeatability of biometric parameters obtained with a new swept-source biometer and to compare the agreement with that of partial coherence interferometry (PCI) and optical low-coherence reflectometry (OLCR). Setting Department of Ophthalmology, Helios Hospital Erfurt, Erfurt, Julius-Maximilians University, Würzburg, and Philipps University, Marburg, Germany. Design Prospective comparative multicenter clinical study. Methods Biometry was taken with the use of 3 different biometers: the IOLMaster 700 swept-source biometer, the PCI-based IOLMaster 500, and the OCLR-based Lenstar LS 900. Axial length (AL), anterior chamber depth (ACD), and spherical equivalent (SE) were compared between swept-source and PCI biometry and central ...

Purpose To compare corneal thickness and epithelial thickness measurements in maps obtained using the RTVue spectral domain optical coherence tomography (SD-OCT) system and the Artemis 2 immersion arc-scanning very-high-frequency ultrasound (VHF-US) system. Setting Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA. Design Comparative study. Methods Eyes of normal volunteers were scanned with the SD-OCT system followed by the VHF-US system and then again by the SD-OCT system. On each map, the minimum corneal thickness and mean values of corneal thickness and epithelial thickness in the 3.0 mm radius zone and in 0.5 mm wide ...