Hinnig Rodrigo Braz, Martins Luiz Felipe Silva, Penha Fernando Marcondes
Fundacao Universidade Regional de Blumenau, Rua Antonio Veiga 140 ZIP, Blumenau, SC, 89030-903, Brazil.
Botelho Hospital da Visão, Rua 2 de Setembro 2958, Blumenau, SC, 89052-504, Brazil.
Int J Retina Vitreous. 2022 Oct 22;8(1):77. doi: 10.1186/s40942-022-00427-8.
Cataract surgery with multifocal IOLs could give patients good vision and great satisfaction, at the same time generating high expectations; therefore, its precise indication is essential if we are to reach our goal. The use of optical coherence tomography may be a valuable tool in the screening of macular diseases, which often cannot be detected in routine clinical examinations. This study evaluates the benefit of including spectral domain optical coherence tomography (SD-OCT) in routine preoperative cataract surgery protocols for better case selection in multifocal IOLs.
Observational and retrospective clinical study that includes patients with an indication for multifocal IOL implantation who underwent retinal fundus exam and SD-OCT examination between 2018 and 2019. The clinical examination with ophthalmoscopy and SD-OCT imaging results were evaluated to observe their influence on the final choice of the lens implanted lens in cataract surgery.
405 eyes from 207 patients with multifocal IOL indication were included. It was found that 220 (54.2%) of all indicated multifocal or trifocal IOLs were in fact implanted. The most important reason for not implanting the indicated IOL was financial, in 116 (59.46%) eyes. The second cause were retinal abnormalities detected by SD-OCT, 63 eyes (15.6%). Those abnormalities included dry age-related macular degeneration (AMD) (50.7%), neovascular AMD (3.1%), vitreomacular adhesion (11.1%), diabetic macular edema (3.1%), epiretinal membrane (ERM) (25.3%) and other macular abnormalities (6.3%). Of the 63 eyes with an abnormal SD-OCT result, 44 (69.8%) were also identified by fundus examination. Nineteen (30.2%) eyes had abnormalities detected only by SD-OCT imaging with a normal clinical exam.
Routine use of SD-OCT imaging may help diagnose pre-existing macular pathologies not identified by clinical exam, helping both physicians and patients choose the ideal IOL individually and has the potential to prevent unsatisfactory functional results.
多焦点人工晶状体白内障手术可为患者带来良好视力和高度满意度，同时也引发了很高的期望；因此，若要实现目标，其精确的适应症至关重要。光学相干断层扫描的应用可能是筛查黄斑疾病的一项有价值的工具，而黄斑疾病在常规临床检查中往往难以被检测到。本研究评估了在常规术前白内障手术方案中纳入光谱域光学相干断层扫描（SD - OCT），以便在多焦点人工晶状体植入时更好地进行病例选择的益处。
一项观察性和回顾性临床研究，纳入了2018年至2019年间有植入多焦点人工晶状体适应症且接受了视网膜眼底检查和SD - OCT检查的患者。对眼底镜检查的临床检查结果和SD - OCT成像结果进行评估，以观察它们对白内障手术中最终植入晶状体选择的影响。
纳入了207例有植入多焦点人工晶状体适应症患者的405只眼。结果发现，所有指示植入的多焦点或三焦点人工晶状体中，实际上有220只眼（54.2%）被植入。未植入指示人工晶状体的最重要原因是经济因素，在116只眼（59.46%）中如此。第二个原因是SD - OCT检测到的视网膜异常，共63只眼（15.6%）。这些异常包括干性年龄相关性黄斑变性（AMD）（50.7%）、新生血管性AMD（3.1%）、玻璃体黄斑粘连（11.1%）、糖尿病性黄斑水肿（3.1%）、视网膜前膜（ERM）（25.3%）以及其他黄斑异常（6.
