B scan ultrasonography before surgery in eyes with dense cataracts

• Author Details:   
• Ram Kumar
• Deepti Yadav
• Akash Srivastava

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Aim: To determine the proportion of posterior segment abnormalities in patients with or without risk factors having dense cataract prior to surgery using B scan ultrasonography.
Materials and Methods: A cross sectional study was performed on 240 eyes with dense cataract using B scan ultrasonography. Patients having history of blunt/penetrating trauma, previous ocular surgery or known case of posterior segment pathology were excluded from the study.
Results: Out of 224 patients in our study 152 patients were without any systemic risk factor. 12 patients had diabetes mellitus, 6 patients had hypertension, 42 patients had age Ë‚ 50 years, 16 patients had bilateral dense cataract. 152 patients did not have any systemic risk factor and 2 of them present with detectable posterior segment abnormality on ultrasound. Out of 240 eyes examined 200 eyes did not have any ocular risk factor in which 2 eyes detected with posterior segment abnormality. Out of 22 eyes with posterior synechiae 6 eyes detected with posterior segment abnormality. Out of 8 eyes had iris coloboma 6 eyes detected with posterior segment abnormality, Out of 12 eyes with elevated IOP 4 eyes detected with abnormal ultrasound. Out of 6 eyes with small cornea all 6 eyes detected with abnormal ultrasound. Out of 240 eyes with dense cataract examined preoperatively with B-scan ultrasound 31 eyes had detected with posterior segment abnormality. Out of 240 eyes 10 eyes detected with retinal detachment, 5 eyes detected with PVD, 2 eyes detected with retinal detachment with choroidal coloboma, 2 eyes had vitreous haemorrhage, 4 eyes had choroidal coloboma with optic disc coloboma, 4 eyes had posterior staphyloma, 4 eyes had cupping of optic nerve head.
Conclusion: In our study Patients with systemic and ocular risk factors showed high incidence of posterior segment pathology. Ideally all the patients with dense cataract should undergo with a B scan examination but most patients with dense cataract are currently encountered in developing countries, most hospitals in these area do not have an easy access to ultrasound So the patients with systemic and ocular risk factors should be referred to the centers where the facility is available in order to plan better management and to determine proper visual prognosis before surgery.

Keywords: B scan ultrasonography, Dense cataract, PVD, Retinal Detachment.