Feasibility and clinical significance of intraoperative real-time fundus examination in cataractous eyes

Authors: Su Shu,  Wu Si,  Wu Jian,  Guan Yu,  Wang Yong,  Yang Mei,  Ji Min,  Guan Huaijin

DOI: 10.3760/cma.j.cn115985.20190928.00422
Published 2020-04-10
Cite as Chin J Exp Ophthalmol, 2020,38(04): 331-335.

Abstract

Objective

To investigate the feasibility of real-time screening and diagnosing fundus diseases with Wild Field Imaging System (WFIS SW-8000) in the eyes with dense cataract patients.

Methods

A series of case-observational study was carried out.Ninety-six dense cataractous eyes of 90 patients with suspected fundus diseases were included in Affiliated Hospital of Nantong University from April to July 2019.Lens phacoemulsification combined with intraocular lens implantation was performed after the opacity lens was removed, and fundus examination was performed with WFIS SW-8000.Super field lens, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) was used to verify the fundus findings after surgery, which were compared with WFIS SW-8000.This study protocol was approved by Ethics Committee of Affiliated Hospital of Nantong University and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.

Results

Among 96 eyes, fundus diseases were detected in 40 eyes with the detection rate of 41.67% by WFIS SW-8000 examination, including dry age-related macular degeneration (AMD) in 2 eyes, wet AMD in 3 eyes, polypoidal choroidal vasculopathy (PCV) in 1 eye, high myopia retinopathy (HMR) in 7 eyes, central retinal vein occlusion (CRVO) with macular edema (ME) in 1 eye, mild non-proliferative diabetic retinopathy (NPDR) in 12 eyes, moderate NPDR in 7 eyes, severe NPDR in 4 eyes and proliferative diabetic retinopathy (PDR) in 3 eyes.Fundus diseases were detected in 45 eyes with detection rate of 46.88% after surgery by a super field lens, OCT and FFA.The detectable rate of digital retinal camera examination and super field lens, OCT and FFA showed no significant difference between intraoperation and postoperation (χ2=0.528, P=0.468). Twenty-two eyes with fundus neovascular disease or macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor (VEGF) drugs were injected in 11 eyes during the operation.

Conclusions

WFIS SW-8000 is a useful tool for the accurate and convenient method in real-time fundus examination during phacoemulsification, which is feasible and helpful for timely intervention in and treatment of fundus diseases.

Key words:

Cataract/surgery; Fundus disease/diagnosis, treatment; Refractive medium; Wild Field Imaging System

Contributor Information

Su Shu
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Wu Si
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Wu Jian
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Guan Yu
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Wang Yong
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Yang Mei
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Ji Min
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
Guan Huaijin
Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
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Updated: May 8, 2020 — 7:50 am