The Decisive Role Of Handheld Erg (Reteval) In Pre-Operative Cataract Assessment: A Grand Synthesis

 To evaluate the utility of handheld electroretinography (ERG) using the RETeval device in the pre-operative assessment of cataract patients, particularly in complex cases involving dense cataracts with no fundal view, and to guide intraocular lens (IOL) selection.

A tertiary referral ophthalmology center.

A retrospective review of complex cataract cases where pre-operative assessment was challenging due to dense media opacities. All patients underwent pre-operative assessment with the RETeval handheld ERG system. Flicker ERG and photopic negative response (PhNR) were recorded. The decision to proceed with surgery was correlated with the ERG findings.

In cases of dense cataracts where fundal view was obscured, the RETeval ERG provided objective, quantitative data on retinal function. Normal ERG responses were predictive of good post-operative visual outcomes, reassuring both the surgeon and patient to proceed with surgery. In patients with underlying retinal pathology, such as diabetic retinopathy or inherited retinal dystrophies, the ERG helped to manage expectations and guide IOL selection, often favoring monofocal lenses. The PhNR was particularly useful in assessing ganglion cell function in patients with co-existing glaucoma. The RETeval DR score was a valuable tool for risk stratification in diabetic patients.

Handheld ERG is an indispensable tool in the pre-operative assessment of complex cataract cases. It provides objective functional data that can penetrate dense media opacities, predict post-operative visual outcomes, and guide IOL selection. The integration of RETeval ERG into routine clinical practice can enhance patient selection, manage expectations, and optimize surgical outcomes in cataract surgery.