Study 1: Evaluation of the signs of deficient posterior capsule in posterior polar cataracts using anterior segment optical coherence tomography
Amar Pujari, Suresh Yadav, Namrata Sharma, Sudarshan Khokhar, Rajesh Sinha, Tushar Agarwal, Jeewan S. Titiyal, Pradeep Sharma
Abstract
PURPOSE: To systematically observe and analyze the signs of deficient posterior capsule in posterior polar cataracts. DESIGN: Ambispective observational study. PARTICIPANTS: Cases with posterior polar cataracts. METHODS: Eyes with diagnosed posterior polar cataracts were imaged on anterior segment optical coherence tomography (AS-OCT). A detailed assessment was performed to note the morphology of the posterior opacity, posterior capsule, and the common patterns to indicate their abnormality. In addition, generalized observation of the morphology was also performed about intraoperative surgical experiences. RESULTS: A total of 101 eyes were included. Mean patient age was 52.85 ± 10.72 years. The posterior capsule integrity was identified as intact in 91 eyes and abnormal/deficient in 10 eyes (9 had intraoperative defective capsule). These deficient/abnormal morphologies were classified into 3 categories: conical (n = 2), moth-eaten (n = 5), and (3) ectatic (n = 3). Similarly, depending on the presence of hypoechoic spaces between the opacity and the capsule, remaining posterior polar cataracts were categorized into 2 generalized morphological types: without hypoechoic areas (n = 40) and with hypoechoic areas (n = 51). In the without hypoechoic areas group, 6 cases developed capsular rent; in the with hypoechoic areas group, 1 case developed capsular rent. CONCLUSIONS: In posterior polar cataracts, the deficient/abnormal capsular morphology could be specifically categorized into 3 categories, conical, moth-eaten, and ectatic types. In addition, to predict the ease of intraoperative separation between the opacity and the capsule, generalized categorization might help in better case management.