“…In this stage, the anterior lens also showed a pronounced anterior bulge, and hence, these eyes carried the maximum risk of rhexis-related complications ( Figure 4 ). 18 Similar to this, we also observed intralenticular changes in three mature brown cataracts, but the changes were variable along the anterior cortex and the anterior nucleus owing to the limited number of cases. 19 Figure 2 In a mature senile cataract, lenticular imaging on a modified OCT shows the presence of horizontal hypoechoic areas within the anterior cortex.…”
Section: Observationssupporting
confidence: 85%
“…2020;68:2099-2102. 18 Figure 4 In the most advanced stage, a major portion of the anterior lens framework is lysed; hence, with subsequent collection of liquefied material, the anterior capsule bulges forward. This stage indicates extensive collection of liquefied material and raised intrabag pressures, which harbour the risk of capsule-related complications.…”
Modern-day cataract surgery has achieved equivalence with refractive surgery, thus requiring surgeons to perform all possible pre-emptive exercises to mitigate intraoperative complications. In this direction, we possess a tremendous amount of technology to understand the preoperative status of the lens. Anterior segment optical coherence tomography (ASOCT) is one such tool, which has played a distinctive role in imaging various forms of cataracts. In this review, we critically analyse the practical role of ASOCT in the preoperative and intraoperative periods from a cataract surgeon’s perspective. After a thorough literature assessment, it was substantiated that the cross-sectional imaging ability of ASOCT can demonstrate delicate anatomical and pathological lenticular changes in a visually and clinically comprehensible way. The objective grading of immature cataracts to intralenticular and posterior capsular details in mature/white, posterior polar, traumatic and other forms of cataracts paves the way for various practical innovations as and when required. Hence, preoperative more than intraoperative ASOCT-derived lenticular knowledge is of immense help in careful surgical planning, with improved complication rates.
“…In this stage, the anterior lens also showed a pronounced anterior bulge, and hence, these eyes carried the maximum risk of rhexis-related complications ( Figure 4 ). 18 Similar to this, we also observed intralenticular changes in three mature brown cataracts, but the changes were variable along the anterior cortex and the anterior nucleus owing to the limited number of cases. 19 Figure 2 In a mature senile cataract, lenticular imaging on a modified OCT shows the presence of horizontal hypoechoic areas within the anterior cortex.…”
Section: Observationssupporting
confidence: 85%
“…2020;68:2099-2102. 18 Figure 4 In the most advanced stage, a major portion of the anterior lens framework is lysed; hence, with subsequent collection of liquefied material, the anterior capsule bulges forward. This stage indicates extensive collection of liquefied material and raised intrabag pressures, which harbour the risk of capsule-related complications.…”
Modern-day cataract surgery has achieved equivalence with refractive surgery, thus requiring surgeons to perform all possible pre-emptive exercises to mitigate intraoperative complications. In this direction, we possess a tremendous amount of technology to understand the preoperative status of the lens. Anterior segment optical coherence tomography (ASOCT) is one such tool, which has played a distinctive role in imaging various forms of cataracts. In this review, we critically analyse the practical role of ASOCT in the preoperative and intraoperative periods from a cataract surgeon’s perspective. After a thorough literature assessment, it was substantiated that the cross-sectional imaging ability of ASOCT can demonstrate delicate anatomical and pathological lenticular changes in a visually and clinically comprehensible way. The objective grading of immature cataracts to intralenticular and posterior capsular details in mature/white, posterior polar, traumatic and other forms of cataracts paves the way for various practical innovations as and when required. Hence, preoperative more than intraoperative ASOCT-derived lenticular knowledge is of immense help in careful surgical planning, with improved complication rates.
“…С помощью этого исследования получают изображения различных слоев хрусталика с высоким разрешением. При зрелой катаракте можно определить деградацию вещества хрусталика, наличие вакуолей и участков лизиса, дефекты задней капсулы [5,16].…”
Section: резюмеunclassified
“…Новая технология Swept source -оптическая когерентная томография (SS-OКT) с переменной длиной волны и высокочастотным детектором позволяет проводить более глубокую и детальную визуализацию переднего отдела глаза, включая денситометрию кортикальных слоев и ядра хрусталика, при этом возможно получить изображение помутнений в виде их картирования в микро-и макромасштабе. По мнению А. Pujari и соавт., проведение данного исследования в предоперационном периоде у пациентов со зрелой катарактой играет значимую роль для профилактики интраоперационных осложнений и оптимальной тактики ведения пациента [16]. С. Panthier и соавт.…”
Literature review is devoted to modern high-technology instrumental methods of the lens evaluation, which have been developed to improve efficiency of the diagnostics and management of cataract in ophthalmological clinical practice. The slit-lamp examination of lens and retroillumination images are used for subjective assessment of cataract according to LOCS III grading system. Currently objective methods of lens evaluation have practical value and provide information about early age-related changes of crystalline lens with the quantitative assessment of the severity of opacities including the optical and ultrasound examinations. Optical methods include densitometry using Scheimpflug images obtained from applications to quantify the localization of lens opacities and their progression rate. Another method is the intensity distribution analysis of the wave front of the optical aberrations according to grading cataract severity with the objective scatter index (OSI) obtained by double-pass technology. Moreover the optical quantitative assessment of lens opacities is carried out by the Shack—Hartmann wave front sensor to identify the grade of nuclear opalescence (N-type) with the Lens Opacities Classification System III. This method is very helpful in nuclear cataract. Swept source optical coherent tomography (SS-OCT) with variable length of wave and high frequency detector is used for the density measurements of nuclear and cortical opacities of lens imaging in micro- and macro dimensional scale. Ultrasound biomicroscopy is the most informative ultrasonic diagnostic method for the evaluation of acoustic density and early age-related changes of lens. Current high-informative methods of quantitative assessment of the optical density of lens are helpful in determination of indications for surgery, the optimization of phacoemulsification settings and prevention of intraoperative complications. The use of high-technologic methods demonstrated the effectiveness of eye drops 0,005 % pirenoxine in early lens opacities management.
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