Preoperative Evaluation of White Cataracts with the Pentacam

To evaluate the use of the Pentacam to analyse the presence or absence of fluid pockets under the anterior capsule and their significance in terms of surgical management and prevention of complications.

Abant İzzet Baysal University Hospital, Bolu, Turkey DESIGN: Randomized, masked, prospective design METHODS: 60 patients with mature cataracts underwent standard phacoemulsification (Phaco) and intraocular lens (IOL) implantation. Patients were divided into 3 groups. Group 1 underwent Phaco+IOL implantation without imaging by Pentacam. Group 2 had fluid detected in Pentacam imaging before the operation and underwent Phaco+IOL implantation with Brazilian method. Group 3 had no fluid detected in Pentacam imaging before the operation and underwent standart Phaco+IOL implantation operation.

When the complication rates of 3 different groups were examined separately, they were found to be 15 % in group 1; 5 % in group 2 and 5 % in group 3, respectively. When compared in pairs as Group 1-2, 1-3, and 2-3, respectively (p < 0.01), (p < 0.01), (p > 0.05). The nuclear density of Group 2 and Group 3 was measured, resulting in 30.2 % and 29.6 %, respectively (P = 0.614). Lens thickness, patients with fluid (+) had a thickness of 5.35 mm, while patients with fluid (-) had a thickness of 3.96 mm (p < 0.05).

Patients who are not imaged with pentacam before surgery experience more complications than other groups because the presence of fluid is unknown. Central lens thickness was higher in patients with fluid, and there was no significant difference in nuclear density between the groups with and without fluid. Pentacam can show the presence of supcapsular fluid and we recommend that imaging tools be more widely used in cataract surgery. We think that this will enable surgeons to make a more accurate surgical planning and reduce the risk of complications.