Detection of a white cataract with elevated intralenticular pressure using an optical biometer based on swept-source...

Area of Science:

• Ophthalmology
• Biomedical Optics
• Medical Imaging

Background:

• White cataract (WC) poses diagnostic challenges, particularly differentiating elevated intralententicular pressure (EWC) from normal intralententicular pressure (NWC).
• Accurate differentiation is crucial for surgical planning and patient outcomes in cataract surgery.

Purpose of the Study:

• To evaluate the efficacy of an optical biometer utilizing Swept-Source Optical Coherence Tomography (SS-OCT) in distinguishing between EWC and NWC.
• To identify specific SS-OCT parameters that can reliably differentiate these two conditions.

Main Methods:

• A retrospective observational study involving 48 patients with WC undergoing phacoemulsification.
• Classification of WC into EWC and NWC groups based on surgical video analysis of liquefied cortex behavior.
• Comparison of demographic data, ocular comorbidities, and SS-OCT parameters (lens thickness, anterior chamber depth) between EWC and NWC groups.

Main Results:

• Significant differences were observed in lens thickness (LT), anterior chamber depth (ACD), and their respective changes (ΔLT, ΔACD) between EWC and NWC groups.
• Receiver Operating Characteristic (ROC) analysis demonstrated high diagnostic accuracy with Area Under the Curve (AUC) values exceeding 0.970 for LT, ΔLT, and ΔACD.
• Image evaluation for EWC detection achieved a sensitivity of 88.5% and a specificity of 90.9%.

Conclusions:

• Optical biometry with SS-OCT shows promise in differentiating EWC from NWC.
• LT, ΔLT, and ΔACD are valuable quantitative parameters for detecting EWC.
• SS-OCT imaging analysis provides a reliable method for identifying EWC.