60 | EYEWORLD | JUNE 2022
ATARACT
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Figure 1. Intraoperative OCT showing phaco
groove depth and shape
Figure 3. Intraoperative OCT showing
pseudoexfoliation material on the anterior
lens surface
Figure 4. Layer of fluid revealed behind the nucleus and a small layer of residual lens
cortex after hydrodissection, imaged by intraoperative OCT
Figure 2. Intraoperative OCT showing posterior subcapsular cataract
Dr. Vasavada added that he's used AS-
OCT for a long time in cases of posterior polar
cataract. For these, it can help determine the
location and extent. If it's unclear on slit lamp
exam if it's a plaque or posterior polar cataract,
Dr. Vasavada said AS-OCT can provide that addi-
tional assurance.
"I think if you want to deliver the best care
… it is useful to incorporate anterior segment
OCT," he said, adding that there is an increasing
trend in the use of this technology in the context
of cataract surgery.
Intraoperative potential
Ronald Yeoh, MD, shared some of his insights
about intraoperative OCT for cataract surgery.
He said intraoperative OCT was introduced
several years ago as a tool for vitreoretinal sur-
geons to assist in peeling the epiretinal mem-
brane and internal limiting membranes from
the macula, as well as to assist corneal surgeons
as they visualize corneal layers during lamellar
surgery.
"It was interesting that in the marketing
literature provided, there was no mention of
its use in cataract surgery, despite the fact that
cataract surgery has more volume than retinal
and corneal surgeries put together," Dr. Yeoh
said. "This was maybe because there was a
perception that modern phaco cataract surgery
is so well developed that an added imaging
technique like intraoperative OCT would not be
