Accuracy of swept source optical coherence tomography and ultrasound biomicroscopy for evaluation of posterior lens capsule in traumatic cataract.

PURPOSE: To assess the efficacy of swept source optical coherence tomography (SS-OCT) and ultrasound biomicroscopy (UBM) in detecting posterior capsule (PC) defect in patients with traumatic cataract. DESIGN: Observational case-series METHODS: Sixty-seven eyes from 67 patients, without age limitation and with traumatic cataract severe enough to prevent slit lamp evaluation of the PC, included in a simple sequence without randomization. Patients underwent both 50 MHz UBM and SS-OCT evaluation of the PC by different operators. Then, cataract surgery was performed using a single technique. RESULTS: Sixty-seven eyes from 67 patients including 60 men and 7 women were studied. The mean age was 34+/-14 years and the mean LogMAR of visual acuity was 1.89+/-0.71. The calculated sensitivity, specificity, and accuracy values for SS-OCT were 96.8% (95% CI: 83.81-99.43), 66.7% (95% CI: 48.78-80.77), and 82% (95% CI: 70.53-89.62) respectively. For UBM, sensitivity, specificity, and accuracy values were 82.6% (95% CI: 62.86-93.02), 57.9% (95% CI: 36.28-76.86), and 71.4% (95% CI: 56.43-82.83), respectively. Positive predictive and negative predictive values for SS-OCT were 75% (95% CI: 59.81-85.81) and 95.2% (95% CI: 77.33-99.15) and for UBM were 70.4% (95% CI: 51.52-84.15) and 73.3% (95% CI: 48.05-89.1), respectively. CONCLUSION: Although both imaging techniques are effective, SS-OCT appears to be at least comparable, or superior in special circumstances, to UBM in detecting preoperative posttraumatic PC rupture. We recommend preoperative assessment of all traumatic cataracts with SS-OCT as a part of surgical planning.