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Advisor(s)
Abstract(s)
Introdução: A biometria ótica é um dos exames que fazem parte do protocolo pré-operatório de cirurgia de catarata. Este exame permite realizar medições de diversas estruturas do olho para calcular a lente intraocular que mais se adequa a cada candidato à cirurgia de catarata, permitindo, ainda, que após a facestomia se obtenha uma melhoria da acuidade visual. Para além da potência da lente que é introduzida durante a cirurgia de catarata, existem outros parâmetros que poderão influenciar o prognóstico pós-cirurgia, nomeadamente as alterações da retina. Para tal, é importante nos exames pré-cirurgia de catarata realizar a tomografia de coerência óptica (OCT) para a avaliação de alterações da retina. No entanto, este é um exame prescrito em diversas situações, tendo por isso mesmo uma lista de espera considerável. Metodologia: A amostra foi selecionada por conveniência e engloba 117 olhos de candidatos a cirurgia de catarata, que realizaram biometria ótica entre os dias 23 de dezembro de 2015 e 23 de abril de 2016, e que não tivessem sido submetidos a cirurgia de catarata anteriormente, nem apresentassem diagnóstico de patologia ocular. Resultados: No presente estudo, o biómetro ótico LS 900® apresentou uma sensibilidade igual a 1 e especificidade igual a 0,902. Relativamente ao valor de eficiência global do teste para deteção de alterações da espessura macular, este apresentou um valor de aproximadamente 0,932. Calculou-se ainda a área abaixo da curva (AUC), obtendo-se um valor de 0,965 com valor-p ˂0,001 e IC de 95% de 0,91 e 1. Conclusão: O biómetro ótico LS 900® revelou ser um dispositivo médico com uma elevada sensibilidade e especificidade para avaliar a espessura macular, quando comparado com o OCT. Mostrou-se ainda um exame de diagnóstico com uma elevada capacidade para deteção de alterações maculares. Assim, com base nos resultados obtidos, conclui-se que o biómetro ótico LS 900® poderá ser utilizado como exame de triagem para a necessidade de OCT nos candidatos a cirurgia de catarata, podendo, desta forma, levar a uma otimização dos recursos e à redução da lista de espera de OCT.
ABSTRACT - Introduction: Optical biometry is one of the exams that are part of the preoperative protocol for cataract surgery. This examination allows measurements of various structures of the eye to calculate the intraocular lens (IOL) that best suits each candidate for cataract surgery, and also allows an improvement of visual acuity after the procedure. In addition to the power of the lens that is introduced during cataract surgery, there are other parameters that may influence the prognosis after surgery, namely retinal changes. For this, it is important in preoperative cataract exams to perform optical coherence tomography (OCT) for the evaluation of retinal changes. However, this is a prescribed examination in several situations, thus having a considerable waiting list. Methodology: The sample was selected by convenience and included 117 eyes of candidates for cataract surgery, who performed optical biometrics between December 23, 2015, and April 23, 2016, and who had not undergone cataract surgery before, not presented a diagnosis of ocular pathology. Results: In the present study, the LS 900® optical biometer had a sensitivity equal to 1 and specificity equal to 0.902. Regarding the overall efficiency value of the test for detection of changes in macular thickness, it presented a value of approximately 0.932. The area under (AUC) the receiver operating characteristic (ROC) was also calculated, yielding a value of 0.965 with p-value ˂0.001 and a 95% CI of 0.91 and 1. Conclusion: The LS 900® optical biometer proved to be a medical device with a high sensitivity and specificity to evaluate the macular thickness when compared to the OCT. A diagnostic test with a high capacity for detecting macular changes was also shown. Thus, based on the results obtained, it can be concluded that the LS 900® optical biometer can be used as a screening test for the need for OCT in the candidates for cataract surgery, which can lead to an optimization of the resources and the reduction of the OCT waiting list.
ABSTRACT - Introduction: Optical biometry is one of the exams that are part of the preoperative protocol for cataract surgery. This examination allows measurements of various structures of the eye to calculate the intraocular lens (IOL) that best suits each candidate for cataract surgery, and also allows an improvement of visual acuity after the procedure. In addition to the power of the lens that is introduced during cataract surgery, there are other parameters that may influence the prognosis after surgery, namely retinal changes. For this, it is important in preoperative cataract exams to perform optical coherence tomography (OCT) for the evaluation of retinal changes. However, this is a prescribed examination in several situations, thus having a considerable waiting list. Methodology: The sample was selected by convenience and included 117 eyes of candidates for cataract surgery, who performed optical biometrics between December 23, 2015, and April 23, 2016, and who had not undergone cataract surgery before, not presented a diagnosis of ocular pathology. Results: In the present study, the LS 900® optical biometer had a sensitivity equal to 1 and specificity equal to 0.902. Regarding the overall efficiency value of the test for detection of changes in macular thickness, it presented a value of approximately 0.932. The area under (AUC) the receiver operating characteristic (ROC) was also calculated, yielding a value of 0.965 with p-value ˂0.001 and a 95% CI of 0.91 and 1. Conclusion: The LS 900® optical biometer proved to be a medical device with a high sensitivity and specificity to evaluate the macular thickness when compared to the OCT. A diagnostic test with a high capacity for detecting macular changes was also shown. Thus, based on the results obtained, it can be concluded that the LS 900® optical biometer can be used as a screening test for the need for OCT in the candidates for cataract surgery, which can lead to an optimization of the resources and the reduction of the OCT waiting list.
Description
Mestrado em Gestão e Avaliação de Tecnologias em Saúde
Keywords
Oftalmologia Catarata Cirurgia Biometria ótica LS 900 Tomografia de coerência óptica Ophthalmology Cataract Surgery Optical biometry Optical coherence tomography
Citation
Barata MJ. Avaliação da capacidade de diagnóstico da biometria ótica na deteção de alterações da espessura macular em candidatos a cirurgia de catarata [Dissertação]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2017.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa