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Postoperative visual acuity predicting in patients with cataract combined with corneal astigmatism

Session Details

Session Title: Assessment of Astigmatism

Session Date/Time: Saturday 05/10/2013 | 11:00-12:30

Paper Time: 12:16

Venue: Main Lecture Hall (Ground Floor)

First Author: : A.Demidov RUSSIA

Co Author(s): :    A. Samoylov              

Abstract Details

Purpose:

Predicting of postoperative visual acuity using retinal vision acuity assessment in cataractous patients with corneal astigmatism planned for phacoemulsification with toric IOL implantation.

Setting:

The study group composed of 43 eyes of patients aged 47 to 74 years with cataract grade I to III and mean corneal astigmatism 2,53±0,95 diopters. Cataract density selection criteria was ability of posterior pole retina visualization using direct or indirect ophthalmoscopy. Mean preoperative BCVA in selected group was 0,23±0,10. Mean retrospective BCVA (BCVA before cataract formation) was 0,47±0,11. Mean RVA before surgery was 0,67±0,12. Patients with irregular corneal astigmatism, corneal opacities, diabetic retinopathy, exudative AMD, and macular oedema were excluded from the study.

Methods:

Preoperative examination included uncorrected and best corrected visual acuity (BCVA) assessment (Snellen), keratorefractometry, ultrasound scanning in A and B modes, biomicroscopy and ophthalomoscopy. Retinal vision acuity (RVA) measurement were performed using HEINE LAMBDA 100 retinometer. IOL"s spheric power calculation was made using IOL-Master (Carl Zeiss) and ultrasound contact biometry. IOL toric power was calculated using Alcon online calculator (www.AcrySofToricCalculator.com). Phacoemulsification through 2,2 mm incision with Alcon AcrySof Toric (T3-T9) IOL implantation were performed in all cases uneventfully. At the 3rd month postoperative examination uncorrected and best corrected visual acuity, keratorefractometic and biomicroscopic findings were recorded.

Results:

At 3rd month after surgery BCVA improved on 0,49±0,09 (from 0,23±0,10 to 0,72±0,10). In prognosis based on retrospective data estimated BCVA improvement was 0,21±0,05 (from 0,23±0,10 to 0,47±0,11). In prognosis based on preoperative RVA data estimated BCVA improvement was 0,44±0,12 (from 0,23±0,10 to 0,67±0,12). Difference between retrospective based prognosis and real BCVA improvement was found significant 0,25±0,05 (р≤0,05). Difference between RVA based prognosis and real BCVA improvement was found not significant 0,04±0,07 (p≥0,05).

Conclusions:

In comparison to traditional historical method, retinal vision measurement is much more accurate, reliable and statistically significantly better method of predicting postoperative visual acuity in patients with cataract combined with regular corneal astigmatism.

Financial Interest:

NONE