Ultrasonic assessment in pre-operative cataract patients

The ability to examine the posterior segment of the eye accurately in patients with opaque media is essential to good surgical care of the cataract patient. In dense cataracts, the posterior segment is inaccessible to direct and indirect ophthalmoscopy and so adequate evaluation of posterior segment to exclude abnormalities become difficult. There is a risk of poor prognosis in eyes of patients with cataracts who may also have co-existing posterior segment abnormalities. Ultrasonography provides a method of assessing the structural changes in the posterior segment of the eye in such patients.

To determine the relevance and prevalence of posterior segment abnormalities in patients with dense cataracts prior to surgery by ultrasonography.

A 12- month prospective study of patients with clinically diagnosed dense cataracts in either or both eyes, in which the posterior segment cannot be evaluated properly during ophthalmoscopy, and therefore were sent for ocular ultrasonography. B-scan ultrasound was done on 116 eyes of 80 patients.

Eighty patients were involved in the study, 116 eyes demonstrated dense cataract. One hundred and ten eyes (94.8%) had a normal posterior segment. Total retinal detachment was noted in 3 eyes (2.59%), a left partial retinal detachment was observed in 1 eye (0.87%), 2 eyes with total retinal detachment in conjunction with vitreous haemorrhage were noted in a single patient, 1.72%

Posterior segment assessment with ultrasound is advisable and important in the preoperative evaluation of patients with dense cataract prior to surgery.