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First Author: S.Kaynak TURKEY
Co Author(s): D. Cam R. Yildirim T. Ozturk M. Kaya N. Kocak
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To evaluate the reliability of potential acuity-meter (PAM) predictions of postoperative visual outcomes in patients undergoing uneventful phacoemulsi?cation and to assess the changes of contrast sensitivity (CS) at early postoperative period.
Department of Ophthalmology, Dokuz Eylul University Hospital, Izmir, Turkey
40 eyes of 35 patient with visually significant cataract were included in this prospective study. Patients with any other ocular pathology except cataract formation, and those with complicated cataract surgeries were excluded. Best corrected visual acuity (BCVA) was measured preoperatively as well as at the first and the third months of postoperative follow-up. All patients had PAM evaluation before surgery, and these results were compared with the final postoperative visual acuity. Study population was divided into two subgroups with respect of the preoperative BCVA being > logMAR 0.5 and ? logMAR 0.5 that was evaluated with Snellen chart. The reliability of PAM predictions of postoperative visual outcomes was also compared between the two subgroups. Contrast sensitivity at five spatial frequencies (1.5, 3, 6, 12, and 18 cycles per degree) was measured by Functional Acuity Contrast Test (Stereo Optical Co., Chicago, USA) under photopic (85 cd/m2) and mesopic (3 cd/m2) conditions at the first and the third months of postoperative follow-up. Test scores was statistically analyzed using paired-sample t-test and Pearson correlation tests.
Of the 35 patients with the mean age of 67.0 ±10.0 years (35-83). Mean preoperative BCVA was found as logMAR 0.60ḟ0.26, and the mean of preoperative PAM scores was logMAR 0.35ḟ0.28. Mean BCVA scores at the third month of the postoperative follow-up was measured as logMAR 0.03ḟ0.12. Mean BCVA scores statistically improved after an uneventful cataract surgery (p=0.000). PAM predicted postoperative BCVA within two line in 20 eyes (50.0%). Although no statistically significant correlation was present between PAM scores and BCVA measured at the third month of postoperative follow-up in the whole study population (p=0.604). PAM scores was found as positively correlated with BCVA that was evaluated at the third follow-up month in patients whose preoperative BCVA was equal or less than logMAR 0.5 (p=0.002). Mean CS scores for frequencies 1.5, 3, 6, 12 and 18 cycles per degree was evaluated for mesopic and photopic conditions in the first and the third months of the postoperative follow-up, however no statistically significant difference was found in CS scores between the first and the third months of follow-up (p>0.05).
PAM may be used as a complementary tool in predicting postoperative visual outcomes. However the reliability of PAM decreased in patients with poorer preoperative BCVA possibly related with dense cataract.