White Cataract Intralenticular Changes In Anterior Segment Optical Coherence Tomography (As-Oct) And Surgical Management

To evaluate morphological characteristics using anterior segment optical coherence tomography (AS-OCT), ocular biometry and track intraoperative complications in white and nuclear cataract patients. Literature suggests, that anterior lens capsule complex (ALCC) increases with age. However, little is known about the measurement of ALCC in white cataract and its’ association with capsulorhexis related complications.

The study was carried out in Lithuanian University of Health Sciences Hospital Ophthalmology Clinic. The study adhered to the principles of Declaration of Helsinki. An informed consent form was signed be all participants.

A total of 42 eyes were included in the study. The study group included white cataract patients and the control group included nuclear cataract patients. Prior to cataract surgery all participants underwent AS-OCT lens imaging (DRI OCT Triton plus (Ver.10.13). Ocular biometry was performed using OcuScan RxP (Alcon Laboratories, USA). ALCC (anterior lens capsule with the accompanying monolayer subcapsular epithelium) was evaluated in AS-OCT images manually. The primary outcome was comparison of anterior chamber depth (ACD), lens thickness (LT) and ALCC between white cataract and control groups. The secondary outcome measure was capsulorhexis-related complications and association with ACD, LT and LCC.

The white cataract group – 23 patients (male 47,8%), the control group – 19 patients (male 38.9%). The mean age in white cataract group was 71.0 (9.3)y.; in control group – 74.0 (7.3) y. (p < 0,05). The ACD mean (SD)(mm) was 3.1 (0.4) in control group and 3.0(0.5) in white cataract group (p=0.193). The LT mean (SD)(mm) was 4.5 (0.4) in control group and 4.5 (0.6) in white cataract group (p =0.370). The ALCC mean (SD)(mm) was 45.6 (6.1) in control group and 44.2 (9.2) in white cataract group (p = 0.349). The ACD and LT correlated in control group (r = -0,756, p < 0.001) and in white cataract group (r = -0,568, p = 0.005). The ALCC did not correlate with ACD and LT in both groups. Capsulorhexis was achieved in all cases without complications.

While the ACD and LT did not differ between white and nuclear cataract groups, ACD was dependent on LT in both groups. The ALCC thickness did not influence ACD-LT  relationship in both groups. Successful capsulorhexis was achieved in all cases.