Table 1.
Characteristics, quality, and level of evidence of the included studies and features of the anterior segment intraoperative optical coherence tomography (i-OCT) cited by these articles.
| Author | Year | Study Design |
Study Sample |
Type of Surgery (n° of Eyes) |
Type of Cataract (n°) |
Intraoperative OCT (i-OCT) Specifications | Ocular Evaluation |
Results | Grade 1 | Level 2 |
|---|---|---|---|---|---|---|---|---|---|---|
| Das S. | 2016 | Prospective study (P) | 38 eyes (E) | Microincision cataract surgery (MICS) (28); femtosecond laser assisted cataract surgery (FLACS) (10) | Posterior polar cataracts (PPCs) (3); mature intumescent cataracts (2); nuclear cataracts (N) grade 2–3 (33). | RESCANTM 700 (Carl Zeiss Meditec) | To describe the role of i-OCT in MICS and FLACS, focusing on wound assessment, capsulorhexis, hydroprocedures, nucleus management, intraocular lens (IOL) assessment | I-OCT could be useful for assessing wound morphology, deciding the adequate depth of trenching, and detecting intraocular lens (IOL) position. | Low | 4 |
| Tañá-Sanz P. | 2021 | P | 102 E | FLACS | Not specified (NS) | Catalys (Johnson & Johnson Vision) | To compare different parameters obtained by i-OCT (before starting surgery) and preoperative OCT biometry. | Measurements provided by Catalys, IOLMaster 700 (Carl Zeiss Meditec) and Anterion (Heidelberg Engineering) are significantly different. |
Low | 4 |
| Waring G.O. 4th | 2020 | Retrospective study (R) | 293 E | FLACS (235); femtosecond laser-assisted refractive lens exchange (58) | NS | Catalys | To analyze the existing relationship among i-OCT-derived lens parameters, biometry, and age. | Commonly available biometric data couldn’t predict i-OCT-derived lens parameters such as lens diameter and lens volume. | Moderate | 4 |
| Hirnschall N. | 2013 | P | 70 E | MICS | NS | Visante (Carl Zeiss Meditec) | To analyze the potential role of i-OCT-derived parameters (acquired after crystalline lens removal) in prediction of postoperative IOL position | I-OCT measurement of anterior capsule position after capsular tension ring (CTR) insertion was a better predictor of the early postoperative IOL position compared with preoperative data. | Low | 4 |
| Kurosawa M. | 2021 | R | 1070 E | FLACS | NS | Catalys | To study whether comparing preoperatively and intraoperatively acquired lens thickness (LT) could help in preventing surgical complications during nuclear laser irradiation in FLACS. | LT inspection could be useful to reduce inappropriate posterior capsule detection cases and consequently misdirected femtosecond laser spots. | Low | 4 |
| Palanker D.V. | 2010 | P | 30 patients | MICS (30); FLACS (29) | N grade 1 to 4 | Frequency-domain OCT (FD-OCT) model integrated on microscope | To develop a model of i-OCT-guided FLACS and to compare it with MICS, focusing on the capsulotomy step. | Capsulotomies performed by OCT-guided femtosecond lasers were characterized by sizes and shapes which were more similar to the intended ones than manual capsulorhexis. | Low | 4 |
| Titiyal J.S. | 2018 | P | 129 E | MICS (77); FLACS (52) | NS | RESCANTM 700 | To evaluate the morphology of clear corneal incisions (CCIs) and their impact on Descemet membrane detachment (DMD). | A ragged morphology of CCIs was associated with a higher incidence of DMD; only i-OCT could detect an increase in its size or its development after stromal hydration. | Low | 4 |
| Song V.K. | 2019 | R | 35 (E) | FLACS | NS | Catalys | To study the anatomical overlap between the pupil center (PC), the limbal center (LC) and the lens center, in order to guide capsulotomy. | The PC was nearer to the lens center than the LC. | Very low | 4 |
| Mastropasqua L. | 2014 | P | 90 E | Lensx (Alcon Laboratories) FLACS (30); Lensar (Lensar) FLACS (30); MICS (30). | NS | Lensx; Lensar | To compare capsulotomies obtained with FLACS with manual capsulorhexis. | FLACS capsulotomies were greater than manual ones, determining a more precise IOL centration. | Moderate | 3 |
| Titiyal J.S. | 2020 | P | 50 E | MICS | White cataracts | RESCANTM 700 | To analyze white cataract morphology and intraoperative dynamics, focusing on capsulorhexis. | I-OCT permitted the identification of four types of white cataracts, based on their anatomical characteristics and surgical behavior during capsulorhexis, helping the surgeon dealing with rhexis’ extension-related complications. | Low | 4 |
| Titiyal J.S. | 2020 | P; R | 112 E | MICS | PPCs | RESCANTM 700 | To evaluate the morphology of PPCs, intraoperative dynamics of the posterior capsule and the occurrence of posterior capsular dehiscence. | I-OCT could help in detecting those PPCs which could undergo safe hydrodissection. | Low | 4 |
| Anisimova N.S. | 2020 | P | 28 videos | MICS (13); FLACS (15) | N | RESCANTM 700 | To identify the presence of incomplete vitreolenticular adhesion, immediately after IOL implantation. | I-OCT permitted the identification of undesired particles into Berger’s space with a higher sensitivity than post-operative OCT. | Very low | 4 |
| Juergens L. | 2021 | P | 4 E | Standard phacoemulsification combined with iris diaphragm implantation | NS | EnFocus Ultra-Deep OCT (Leica Microsystems) | To assess when the use of i-OCT could be relevant for intra- operative procedures. | I-OCT was crucial for the implantation of a two-part brown iris diaphragm, because of the poor contrast between the anterior lens capsule margin and the brown implant. | Very low | 5 |