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. 2019 Nov 12:2019:4903703.
doi: 10.1155/2019/4903703. eCollection 2019.

Application of 14-MHz Ultrasonography with Tissue Harmonic Imaging to Determine Posterior Capsule Integrity in Traumatic Cataract

Bin Wu  1 , Qingyu Li  1 , Yangchen Liu  1 , Di Wu  1 , Jianmin Gao  1 , Yan Li  1 , Xiaoyong Yuan  1
Affiliations

Application of 14-MHz Ultrasonography with Tissue Harmonic Imaging to Determine Posterior Capsule Integrity in Traumatic Cataract

Bin Wu et al. J Ophthalmol. .

Abstract

Purpose: To report the application of 14-MHz ultrasonography with tissue harmonic imaging (14 MHz + THI) to determine the integrity of the posterior capsule (PC) in traumatic cataract (TC).

Methods: Patients with TC who were scheduled to undergo cataract extraction and whose PC could not be observed by slit lamp examination were included in the study. The status of the PC was determined by 14 MHz + THI before cataract extraction and confirmed during surgery. The results regarding PC integrity obtained from 14 MHz + THI and intraoperative direct observation were compared.

Result: The study enrolled 52 eyes of 52 patients (49 men and 3 women), with a mean age of 42.15 years ± 11.23 (SD). The nature of the trauma was blunt (3 eyes) or sharp (49 eyes). The 14 MHz + THI method showed 21 PCs to be intact and 31 to have ruptured before cataract surgery. During surgery, 23 PCs were observed to be intact, while 29 PCs were ruptured. 27 PCs were ruptured and 19 were intact, as determined by the two methods. The 14 MHz + THI observations were consistent with the intraoperative observations of the PC (kappa = 0.764), with no significant difference between the two methods (P=0.687). The sensitivity, specificity, and accuracy of 14 MHz + THI for observation of the PC were 93.10%, 82.60%, and 88.46%, respectively.

Conclusion: The 14 MHz + THI method can accurately reveal the integrity of the PC in TC. It has important clinical value in the selection of cataract surgery methods and the prediction of complications during TC surgery.

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Conflict of interest statement

The authors have no financial or proprietary interest in any material or method mentioned.

Figures

Figure 1
Figure 1
Ruptured PC shown by 14 MHz + THI. (a) A hyperechoic passage is present through the lens to the vitreous body, and the echo of the PC is interrupted (long arrow). (b) The PC shows an irregular oval echo and an uneven echo at the rupture (short arrow).
Figure 2
Figure 2
Intact PC shown by 14 MHz + THI. The shape of the lens is regular, the internal echo is uniform, the anterior capsule is ruptured, and the PC echoes are smooth and continuous.
Figure 3
Figure 3
False-positive image of PC by 14 MHz + THI. (a) The shape of the lens is regular, the internal echo is uniform, and the PC echo is regular. A moderate echo band is shown and was mistaken for a passage (long arrow). (b) The shape of the lens is not regular, the internal echo is not uniform, the anterior capsule is ruptured, and the PC of the equator shows a sharp echo, which was mistaken for rupture (short arrow).
Figure 4
Figure 4
False-negative image of PC by 14 MHz + THI. The lens is dilated and regular in shape, with a cord-like medium echo and smooth, continuous PC echo.
See this image and copyright information in PMC

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