To determine the role of Anterior segment optical coherence topography (AS-OCT) pre- operatively to detect pre-existing weakness of the posterior capsule in patient of posterior polar cataract (PPC) effecting outcomes during phacoemulsification

Abstract

To determine the role of anterior segment optical coherence topography (AS-OCT) pre- operatively to detect pre-existing weakness of the posterior capsule in patient of posterior polar cataract (PPC) effecting outcomes during phacoemulsification.A prospective observational study was done in 26 eyes with clinically diagnosed PPC who underwent phacoemulsification between November 2018 to December 2019. AS-OCT was done preoperatively to detect pre existing dehiscence of posterior capsule in patient of PPC. The images obtained by AS-OCT were divided into either intact or dehiscent. Integrity of posterior capsule was also observed during operation by surgeon.In 26 eyes, dehiscence of posterior capsule was detected in 4 eyes (15.4%) by AS-OCT pre operatively, of posterior capsule in 3 eyes (11.5%) and intact posterior capsule in 23 eyes (88.5%). Rupture of posterior capsule occurred in 4 eyes during phacoemulsification. 3 out of 4 eyes who had rupture, had dehiscence of posterior capsule that was noted by AS-OCT and also intraoperatively while 1 eye was detected to have intact posterior capsule. The sensitivity of AS-OCT was 75% for detecting posterior capsule dehiscence and specificity was 95.65%.: AS-OCT can be used preoperatively to identify posterior polar cataract that are at risk of posterior capsule rupture. This provides preoperative information to surgeon and helps in proper counselling of patients about the prognosis.