Pujari Amar, Sharma Namrata
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Clin Ophthalmol. 2021 Feb 3;15:389-401. doi: 10.2147/OPTH.S286996. eCollection 2021.
Modern-day cataract surgery has achieved equivalence with refractive surgery, thus requiring surgeons to perform all possible pre-emptive exercises to mitigate intraoperative complications. In this direction, we possess a tremendous amount of technology to understand the preoperative status of the lens. Anterior segment optical coherence tomography (ASOCT) is one such tool, which has played a distinctive role in imaging various forms of cataracts. In this review, we critically analyse the practical role of ASOCT in the preoperative and intraoperative periods from a cataract surgeon's perspective. After a thorough literature assessment, it was substantiated that the cross-sectional imaging ability of ASOCT can demonstrate delicate anatomical and pathological lenticular changes in a visually and clinically comprehensible way. The objective grading of immature cataracts to intralenticular and posterior capsular details in mature/white, posterior polar, traumatic and other forms of cataracts paves the way for various practical innovations as and when required. Hence, preoperative more than intraoperative ASOCT-derived lenticular knowledge is of immense help in careful surgical planning, with improved complication rates.
现代白内障手术已达到与屈光手术相当的水平，因此要求外科医生采取一切可能的预防措施以减轻术中并发症。在这方面，我们拥有大量技术来了解晶状体的术前状况。前段光学相干断层扫描（ASOCT）就是这样一种工具，它在各种形式白内障的成像中发挥了独特作用。在本综述中，我们从白内障外科医生的角度批判性地分析了ASOCT在术前和术中阶段的实际作用。经过全面的文献评估，证实了ASOCT的横断面成像能力能够以视觉和临床可理解的方式展示晶状体细微的解剖和病理变化。对未成熟白内障进行客观分级，并了解成熟/白色、后极性、外伤性及其他形式白内障的晶状体内部和后囊膜细节，可为必要时的各种实际创新铺平道路。因此，术前而非术中通过ASOCT获得的晶状体知识，对精心的手术规划有极大帮助，可降低并发症发生率。
