Clinician versus potential acuity test predictions of visual outcome after cataract surgery.
BACKGROUND
The aim of this study was to compare the ability of potential vision tests and clinical judgement to predict postoperative visual acuity after uneventful cataract surgery.


METHODS
Sixty-two subjects (median, 74.5 years) were included in the study. Preoperative measurements included a clinical judgement prediction (based on case history and ocular examination alone), 2 super-illuminated pinhole techniques (distance and near), Potential Acuity Meter and interferometer. Postoperative visual acuity was used as the outcome measure to evaluate the accuracy of the preoperative predictions.


RESULTS
Subjects were categorized as follows: (a) moderate cataract (N = 25); (b) moderate cataract and comorbidity (N = 18), and (c) advanced cataract (N = 19). Preoperative predictions within 2 lines of the postoperative visual acuity were as follows (a, b, and c respectively): clinical judgement (92%, 72%, 58%), super-illuminated pinhole distance (96%, 100%, 21%), super-illuminated pinhole near (92%, 78%, 26%), Potential Acuity Meter (72%, 67%, 21%), and interferometer (56%, 61%, 37%).


CONCLUSIONS
Based on the preoperative predictions above, none of the potential vision tests was useful compared with the clinical judgement in the advanced cataract group. The super-illuminated pinhole (distance) provided additional information beyond clinical judgement in the moderate cataract subgroup. The Potential Acuity Meter and interferometer were inaccurate even in the presence of moderate cataract, and this and other recent findings suggest they should no longer be considered adequate for potential vision assessment.
Vianya-Estopa
Marta
M
Department of Optometry, University of Bradford, Bradford, West Yorkshire, United Kingdom. martavianya@hotmail.com
Douthwaite
William A
WA
Funnell
Charlotte L
CL
Elliott
David B
DB
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D011184:Postoperative Period; D019591:Pseudophakia / Q000503:physiopathology*; D016896:Treatment Outcome; D014787:Vision Tests / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology*