Selection Criteria For Patients With High Visual Acuity For Cataract Surgery

to develop and scientifically substantiate individual criteria for decision making surgical treatment of cataracts with high visual acuity

IRTC Eye Microsurgery Ekaterinburg Center, Ekaterinburg, Russia.

The study enrolled 269 patients. The first stage involved a comparative analysis of clinical and functional parameters in 243 eyes with early cataract (cortical, nuclear, and posterior subcapsular) and 75 eyes without cataract. The second stage included assessment of the efficacyof the developed algorithm for the treatment of early cataracts by analyzing the clinical and functional results after phaco with IOL implantation. All the patients underwent wavefront analysis using the iTraceaberrometer. Total, corneal, and internal wavefront aberrations were studied with pupildiameter of 5.0 mm. The MTF and light scattering function was assessed. All thepatients filled out a questionnaire.

The study results demonstrated a significant increase in internal higher-order aberrations, while the corneal profile remained stable. The nature of optical aberrations corresponded to the cataract type and also correlated with optical phenomena reported in the questionnaire. Nuclear opacities were found to induce a negative shift in spherical aberration, cortical opacities - to increase coma, and posterior capsular opacities - to increase trefoil aberrations.

A decrease in the modulation transfer function (MTF) and the Strehl ratio, most pronounced in posterior capsular cataracts and under mesopic conditions, objectifies the patients' complaints.

Selection criteria for patients with high visual acuity for cataract surgery have been developed. Questionnaires allow more accurate identification of visual discomfort which may not be reflected in standard visual acuity tests. Aberrometry plays a key role in assessing the functional state of vision. This stresses the importance of complex approach to early cataract diagnostics, including both objective and subjective methods, for better understanding of the disease impact on patients' quality of life.