Optical Coherence Tomography: Critical Tool to Manage Expectations after Cataract Extraction

Raquel Goldhardt, Bradley Simon Rosen

Research output: Contribution to journalReview article

Abstract

Purpose of Review: To review evidence on the utility of spectral domain optical coherence tomography (SD-OCT) in evaluating retinal structure prior cataract surgery and highlight new technologies that can assess retinal function perioperatively. Recent Findings: SD-OCT detected clinically unsuspected macular pathology in 4.6–25% of individuals in the pre-operative cataract evaluation. The most common findings were epiretinal membrane and macular degeneration with frequencies that varied by population studied. These conditions have been associated with complication after surgery (e.g., macular edema, visual dissatisfaction). As such, findings on SD-OCT may impact the informed consent process, alter IOL selection, and provide realistic post-operative vision expectations. Other technologies that assess retinal function, such as microperimetry and multifocal ERG are beginning to be studied but their utility in the pre-operative cataract evaluation is not yet known. Summary: SD-OCT should be incorporated as a routine test prior to surgery to manage patient expectations and assist with optimal IOL selection, as even individuals with a seemingly normal clinical exam may have macular pathology. SD-OCT is the most established method for evaluating retinal anatomy and offers the benefits of a reduction in cases with missed macular pathology and fewer post-operative visual surprises.

Original languageEnglish (US)
Pages (from-to)129-135
Number of pages7
JournalCurrent Ophthalmology Reports
Volume8
Issue number3
DOIs
StatePublished - Sep 1 2020

Keywords

  • Cataract surgery
  • Macula pathology
  • Multifocal intraocular lenses
  • Optical coherence tomography
  • Patient expectations
  • Pre-operative evaluation

ASJC Scopus subject areas

  • Ophthalmology

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