AS-OCT may be helpful for assessing postop IOL optic changes

In this experimental study, researchers used explanted IOLs to evaluate the use of anterior segment optical coherence tomography (AS-OCT) in assessing postoperative IOL optic changes. They found that AS-OCT can be helpful but not with identifying more superficial changes.

They used IOLs explanted due to various complications. After gross and light microscopy, they used the Visante time-domain AS-OCT system to examine the IOLs in the dry and hydrated states. Selected hydrophilic acrylic IOLs were stained for calcium. In-the-bag IOLs in pseudophakic cadaver eyes were also evaluated by AS-OCT before and after explantation to confirm correspondence with the clinical situation.

AS-OCT could image intraoptic changes, such as snowflake lesions in PMMA IOLs, calcification in hydrophilic acrylic IOLs and glistenings in hydrophobic acrylic IOLs. The method was also helpful in analyzing the location and density of intraoptic changes. However, more superficial changes could not be clearly differentiated from the overall outline of the IOL surface unless the lesions, deposits or both were present on the optic surface with an extension to the optic substance of at least 0.1 mm.

The authors conclude that AS-OCT may be helpful for assessing the presence, location and density of intraoptic changes, and avoiding a misdiagnosis of IOL opacification and the performance of unnecessary procedures, such as posterior capsulotomy or vitrectomy.