AIM: To investigate the value of 3D- optical coherence tomography(OCT)in the diagnosis of macular disease before phacoemulsification.

METHODS: Clinical records of 423 cataract patients(512 eyes)who underwent phacoemulsification combined with intraocular lens implantation in our hospital from June to December in 2015 were retrospectively analyzed. In addition to preoperative routine examination of fundus, Topcon 3D-OCT 2000 was used to examine the macula, the detection rate of macular disease was compared, risk factors of cataract combined with macular disease were analyzed.

RESULTS: The OCT image results of 305 cases(384 eyes, 72.1%)were successfully obtained, 133 cases showed macular disease(146 eyes), the detection rate was 28.5%(95%CI: 27.64%-29.40%); the macular disease of 35 cases(37 eyes)were detected by routine examination of fundus before operation, the detection rate was 7.2%(95%CI: 6.72%-7.74%); the detection rate of 3D-OCT was significantly higher than routine examination of fundus for macular disease(χ²=79.05, P<0.01). Female, over 65 years old, surgical history of diseased eye, and high myopia were risk factors of cataract combined with macular disease, the relative risk was 1.705(95%CI:1.091,2.664), 1.893(95%CI:1.219,2.939), 6.593(95%CI:2.027,21.447)and 95%CI: 5.130(2.841,9.263)respectively, the risk of cataract combined with macular disease showed an increasing trend with rising age.

CONCLUSION: In preoperative examination of cataract patients, 3D-OCT has higher sensitivity in the detection of macular disease, especially for women, over 65 years old, high myopia and surgical history of diseased eye, 3D-OCT can be used as a routine preoperative examination.