Is retinal acuity meter (RAM) a valuable predictor of postoperative visual acuity in cataract patients?

Session Details

Session Title: Special Cases I

Session Date/Time: Sunday 06/09/2015 | 14:30-16:00

Paper Time: 15:26

Venue: Room 10

First Author: : S.Jain INDIA

Co Author(s): :    K. Srivastava   A. Khandelwal   S. Nair   A. Tara           

Abstract Details

Purpose:

RAM is a device which is considered a valuable predictor of post operative visual acuity in patients with cataract. This study was done to determine the predictive value of RAM in patients who have undergone Cataract surgery.

Setting:

Retrospective single center study at Indira Gandhi Eye Hospital and Research Center, Lucknow,Uttar Pradesh,India. Study period November 2012 to April 2013. RAM testing was already was being performed when indicated. Ethics committee was consulted and confirmation was given that formal ethics approval was not required.

Methods:

82 patients underwent RAM, 43 eyes of 40 patients were included in the study. We recorded pre-operative RAM acuity,cataract grade,presence of associated eye disease & post-operative Best Corrected visual acuity (BCVA). The test was explained to patients. Lambda 100 (HEINE) was used which has six increments. Patient reads in sitting position at a distance of 40 cm. Testing was performed by same technician for all patients to reduce error. Inclusion Criterion: Cataract patients with Retinal/Macular/corneal disease in whom we did not expect BCVA to be 6/6. Exclusion Criterion: Patients who did not undergo surgery until the start of the study.

Results:

Age ranged from 17 to 75 years. 20 males , 20 females (1:1). Pre-operative RAM acuity was 6/12 to 6/6(Logmar 0.301 to 0) in 81.40% eyes (35/43 patients) and 6/36 to 6/18( Logmar 0.778 to 0.477) in 18.60% eyes (8/43 ). Post-operative BCVA was 6/12 to 6/6(Logmar 0.301 to 0 ) in 86.05% (37/43) eyes (6/6 in 65.12% eyes, 6/9 in 16.28% eyes, 6/12 in 4.65% eyes), 6/36 to 6/18(Logmar 0.778 to 0.477) in 6.98% (3/43)eyes and 1/60 to 5/60(Logmar 1.778 to 1.079) in 6.98% (3/43) eyes. Of 5 patients with BCVA lower than predicted, 3 had corneal disease before surgery (Adherent leucoma, Corneal degeneration and Nebular corneal opacity), one had optic pallor and the 5th developed viral corneal ulcer.

Conclusions:

Retinal acuity meter is useful in giving the patients a realistic idea of the BCVA prior to surgery. This helps in preventing disappointment after surgery. Our study clearly indicates that RAM is a valuable predictor of post-operative visual acuity in Cataract patients. RAM quickly establishes the BCVA without formal refraction. Patient satisfaction was established by a simple questionnaire one month post-operatively. Hence RAM testing should be part of pre-operative cataract surgery protocol for cases of Retinal/macular diseases in which we do not expect the BCVA to be 6/6. It is inexpensive, easy for patients and technicians, quick and accurate.

Financial Interest:

NONE