ArticlePreoperative macular spectral-domain optical coherence tomography in patients considering advanced-technology intraocular lenses for cataract surgeryKlein, Betty R. MD*; Brown, Emma N.; Casden, Richard S. MD Author Information From the Western Connecticut Health Network (Klein, Casden), Danbury, Connecticut, and Mt. Holyoke College (Brown), South Hadley, Massachusetts, USA *Corresponding author: Betty R. Klein, MD, 57 North Street, Suite 415, Danbury, Connecticut 06810, USA. E-mail: [email protected] Submitted September 8, 2015; revised December 22, 2015; accepted January 8, 2016.Figure: No Caption available.First author: Betty R. Klein, MD Western Connecticut Health Network, Danbury, Connecticut, USA Presented at the Yale Eye Center Spring Symposium/Alumni Day, Yale Medical School, New Haven, Connecticut, USA, June 2015, and as a poster at the Summer Symposium of Women in Ophthalmology, Scottsdale, Arizona, USA, August 2015. Journal of Cataract & Refractive Surgery 42(4):p 537-541, April 2016. | DOI: 10.1016/j.jcrs.2016.01.036 Buy Metrics Abstract 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, and diabetes. Results Two hundred sixty-five consecutive scans from 149 patients were obtained. Macular pathology was found in 35 eyes (13.2%). The most common condition was age-related macular degeneration in 15 eyes (5.66%) followed by idiopathic epiretinal membrane in 11 eyes (4.15%). Ischemic atrophy from previously undiagnosed retinal vascular pathology was found in 5 eyes (1.89%) and edema in 3 eyes (1.13%). A subgroup analysis found a higher incidence of macular pathology in patients with a history of heart disease (30.6%, P < .001) or smoking (20.2%, P < .05), and in men (23.9%, P < .01). Media opacities precluded interpretation of 17 scans (6.42%). Conclusion Preoperative macular SD-OCT scanning was effective in identifying patients at risk for compromised visual outcomes after advanced-technology IOL surgery. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned. © 2016 by Lippincott Williams & Wilkins, Inc.
