CATARACT EWAP SEPTEMBER 2022 25 Contact information Miller: kmiller@ucla.edu Vasavada: icirc@abhayvasavada.com Yeoh: ersryeoh@gmail.com T he application of anterior segment OCT (AS-OCT) in cataract surgery is relatively new. 1 The authors of a 2021 review of AS-OCT described the current role of the technology and perspectives and its potential future application, concluding: ASOCT technology is comprehensively making progress in the assessment of cataractous eyes in the preoperative as well as intraoperative periods. The positive role of ASOCT in objectifying the cataractous grade, intralenticular changes in white/mature cataracts, and posterior capsular changes in posterior polar and traumatic cataracts cases demonstrates its definite adÕvant role in routine clinical practice. In addition, compared to previous technologies, emerging swept source technology has furthered the cross-sectional imaging as a more practical tool. Hence, ASOCT is likely to become an integral part of assessment when dealing with complex lenticular entities in future. The authors of a chapter in the book OCT Applications in Ophthalmology described the various ways in which they saw value of the technology for cataract surgery, including “(1) anterior lens capsule and lens Anterior segment OCT for cataract surgery: preop, intraop, and postop applications by Liz Hillman Editorial Co-Director epithelium evaluation using spectral-domain O T SD-O T®Æ (2) investigation of clear corneal incision in femtosecond laser assisted cataract surgery using SD-O TÆ Î® capsular block syndrome evaluation before and after treatment using SD-O TÆ [and] (4) IOL power calculation in post-myopic excimer laser eyes using SD-OCT.” 2 A book chapter in High Resolution Imaging in Microscopy and Ophthalmology: New Frontiers in Biomedical Optics described the various technologies with anterior segment OCT capabilities. 3 This article originally appeared in the June 2022 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. While many applications are related to cornea (which can have implications on refractive cataract surgery), some technologies have increasing applications that can aid in IOL calculations, the authors wrote. Preop and postop applications Kevin M. Miller, MD, said preoperative and postoperative imaging with AS-OCT can be helpful. “Preoperatively, anterior segment OCT can be used to identify posterior capsule openings or posterior lenticonus Figure 1. Intraoperative OCT showing phaco groove depth and shape. Figure 2. Intraoperative OCT showing posterior subcapsular cataract.
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