'Association for Research in Vision and Ophthalmology (ARVO)'
Abstract
PURPOSE: To evaluate posterior capsule opacification (PCO) in humans after
cataract surgery with intraocular lens (IOL) implantation, by using optical
coherence tomography (OCT-1). METHODS: Sixty-six eyes with PCO and 20 eyes with a
normal posterior capsule were analyzed. A 3-mm-long horizontal scan of the
posterior capsule was obtained. Measurements at three points and their average
were recorded. Intraoperator and interoperator reliabilities were assessed.
Investigated was peak intensity (PI) and posterior capsule thickening (PCT), with
PCT indicating the distance between two reflectivity spikes, with an approximate
axial resolution of 10 microm. Results were compared with visual acuity (VA) and
PCO type. RESULTS: Intraoperator reliability was 0.59 and 0.97 for average PI and
PCT, respectively. The interoperator concordance correlation coefficient was 0.70
and 0.82 for average PI and PCT, respectively. Median (interquartile range)
intensities of the reflectivity spike were 16.88 (dB) (range, 12.88-20.41) and
11.9 (8.58-14.28), respectively, in the PCO and control eyes (P = 0.001). PCT was
found in PCO eyes (median: 86.13 microm; range, 46.33-115.33), whereas no second
spike appeared in control eyes (P = 0.001). The area under the receiver operating
characteristic curve of the average PCT for differentiating pearl-type from
fibrosis-type PCO was 0.87 (P = 0.001). For a cutoff point of 55.3 microm, the
sensitivity was 97.5%, and the specificity was 69%. Worse VA correlated
significantly only with larger PCT (r(o) = 0.66; P = 0.01). CONCLUSIONS: OCT-1
appears useful to quantitate PCO. In addition, this system seems to discriminate
between different types of PCO. PCT may be a previously unrecognized factor in VA
degradation