Optical Coherence Tomography: Critical Tool to Manage Expectations after Cataract Extraction

Area of Science:

• Ophthalmology
• Medical Imaging

Background:

• Cataract surgery is a common procedure with potential for visual complications.
• Preoperative assessment of retinal structure is crucial for managing patient expectations and surgical outcomes.

Purpose of the Study:

• To review the utility of spectral domain optical coherence tomography (SD-OCT) in preoperative cataract evaluation.
• To highlight emerging technologies for assessing perioperative retinal function.

Main Methods:

• Review of existing evidence on SD-OCT in cataract surgery evaluations.
• Identification of common macular pathologies detected by SD-OCT.
• Exploration of newer functional retinal assessment technologies.

Main Results:

• SD-OCT identified unsuspected macular pathology in 4.6-25% of patients, most commonly epiretinal membranes and macular degeneration.
• Detected pathologies can influence informed consent, intraocular lens (IOL) selection, and postoperative vision predictions.
• Emerging technologies like microperimetry and multifocal ERG are under investigation for preoperative use.

Conclusions:

• SD-OCT should be a routine preoperative test for cataract surgery to manage expectations and optimize IOL selection.
• Even eyes with normal clinical exams may harbor macular pathology detectable by SD-OCT.
• SD-OCT reduces missed pathologies and postoperative visual surprises by evaluating retinal anatomy.