Preoperative macular spectral-domain optical coherence tomography in patients considering advanced-technology intraocular lenses for cataract surgery

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.