First Author: M.Zajac POLAND
Co Author(s): B. Grobarek A. J M. Lewandowska M. Mulak A. Wojtowiec
Purpose:
The aim of this work was to investigate the visual system in patients with cataract by comparing its functioning before and after cataract removal and implanting the artificial intraocular lens (IOL). We also wanted to compare objective indicators of the therapy results with subjective feelings of the patients.
Setting:
: The aim of this work was to investigate the visual system in patients with cataract by comparing its functioning before and after cataract removal and implanting the artificial intraocular lens (IOL). We also wanted to compare objective indicators of the therapy results with subjective feelings of the patients.
Methods:
For all patients the phacoemulsification was performed using small incision in the clear cornea technique and the monofocal Alcon AcrySoft Single Piece IOL was implanted to posterior chamber. Their vision quality was measured with Functional Vision Analyzer Optec®5500P immediately before the surgery as well as about 4 weeks afer surgery during control visit. Far vision Visual Acuity (ETDRS test) and contrast sensitivity (Pelli-Robson test) were measured in the best spectacle correction as determined by autorefractor measurements. The illumination level while vision check was 85 cd/m² which corresponds to the day vision. Visual acuity under glare or through a pin-hole were also measured as these data are useful to evaluate the potential visual acuity (PVA) before surgery.
The above-mentioned measures do not reflect subjective feelings of the patients associated with effects of therapy, and therefore are not sufficient to judge the success or failure of the treatment. To collect the subjective patients opinion a specially adopted Health Related Quality of Life Questionnaire was used
Results:
In the vast majority of patients a significant improvement in the vision quality was observed after cataract surgery (expresed as Best Corrected Visual Acuity as well as Contrast Sensitivity Function). The improvement was observed even in patients with initial changes in the macula (drusen, dry AMD) or amblyopia since childhood. Few cases of the lack of improvement can be explained by coexisting ophthalmic diseases (especially macular degeneration).
Results of PVA measurements were weakly correlated with final value of visual acuity acjhieved after surgery. It is interesting that relatively large number of patients evaluated their ability to function in society as a rather good despite poor eyesight before surgery
Conclusions:
Both visual acuity and contrast sensitivity function improves significantly after cataract surgery and IOL implantation.
The predictive value of the PVA measurement seems to be very limited probably due to difficult procedure and requirements of good cooperation with the patient.
The study of subjective assessment of vision in cataract patients has to be conducted with a very good mutual contact and understanding of survey questions by patients
Work done under Research Project N N518 414138 funded by MNiSW
Financial Disclosure:
None
