Visual field changes after cataract extraction: the AGIS experience.
OBJECTIVE
To test the hypothesis that cataract extraction in glaucomatous eyes improves overall sensitivity of visual function without affecting the size or depth of glaucomatous scotomas.


METHODS
Experimental study with no control group.


METHODS
One hundred fifty-eight eyes (of 140 patients) from the Advanced Glaucoma Intervention Study with at least two reliable visual fields within a year both before and after cataract surgery were included. Average mean deviation (MD), pattern standard deviation (PSD), and corrected pattern standard deviation (CPSD) were compared before and after cataract extraction. To evaluate changes in scotoma size, the number of abnormal points (P < .05) on the pattern deviation plot was compared before and after surgery. We described an index ("scotoma depth index") to investigate changes of scotoma depth after surgery.


RESULTS
Mean values for MD, PSD, and CPSD were -13.2, 6.4, and 5.9 dB before and -11.9, 6.8, and 6.2 dB after cataract surgery (P < or = .001 for all comparisons). Mean (+/- SD) number of abnormal points on pattern deviation plot was 26.7 +/- 9.4 and 27.5 +/- 9.0 before and after cataract surgery, respectively (P = .02). Scotoma depth index did not change after cataract extraction (-19.3 vs -19.2 dB, P = .90).


CONCLUSIONS
Cataract extraction caused generalized improvement of the visual field, which was most marked in eyes with less advanced glaucomatous damage. Although the enlargement of scotomas was statistically significant, it was not clinically meaningful. No improvement of sensitivity was observed in the deepest part of the scotomas.
Koucheki
Behrooz
B
Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California 90095, USA.
Nouri-Mahdavi
Kouros
K
Patel
Gitane
G
Gaasterland
Douglas
D
Caprioli
Joseph
J
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications / Q000503:physiopathology; D002387:Cataract Extraction; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*