Accuracy of 3 imaging modalities for evaluation of the posterior lens capsule in traumatic cataract

PURPOSE: To compare the accuracy of 3 imaging modalities for preoperative evaluation of the posterior lens capsule in traumatic cataract. SETTING: Farabi Eye Hospital, Tehran, Iran. DESIGN: Case series. METHODS: The study comprised eyes with traumatic cataract opaque enough to prevent visualization of the posterior lens capsule on slitlamp examination. To detect posterior lens capsule rupture before surgery, imaging was performed with 20 MHz echography (Eye Cubed), anterior segment optical coherence tomography (AS-OCT) (Visante model 1000), and Scheimpflug imaging (Pentacam). All patients subsequently had cataract extraction, and the intraoperative findings of the posterior lens capsule were compared with the preoperative findings of the imaging modalities. RESULTS: The study enrolled 21 eyes of 21 patients (20 men, 1 woman) with a mean age of 31.5 years +/- 1.45 (SD). The nature of trauma was blunt (5 eyes) or sharp (16 eyes). To detect posterior lens capsule rupture, the sensitivity and specificity were, respectively, 80% and 86% for 20 MHz echography, 71% and 77% for AS-OCT, and 62% and 57% for Scheimpflug imaging (95% confidence intervals: sensitivity, 30.00-90.32; specificity, 54.81-92.95). Insufficient resolution for posterior lens capsule evaluation occurred in 33.3% cases for AS-OCT and 57.1% cases for Scheimpflug imaging. The accuracy of 20 MHz echography, AS-OCT, and Scheimpflug imaging was 76.1%, 61.9%, and 42.9%, respectively. CONCLUSION: In the evaluation of the posterior lens capsule in eyes with traumatic cataract, 20 MHz echography had higher accuracy than AS-OCT and Scheimpflug imaging.