Predicting postoperative visual outcomes in cataract patients with maculopathy.

Area of Science:

• Ophthalmology
• Medical Devices
• Visual Science

Background:

• Cataract surgery aims to restore vision, but predicting postoperative visual acuity can be challenging, especially in patients with coexisting retinal conditions.
• Inactive maculopathies, such as diabetic maculopathy and age-related macular degeneration, can affect visual outcomes after cataract surgery.
• The Potential Acuity Meter (PAM) is a device designed to estimate the eye's visual potential by bypassing the optical aberrations of the cataract.

Purpose of the Study:

• To evaluate the predictive accuracy of the Potential Acuity Meter (PAM) for visual acuity outcomes following cataract surgery in patients with healed, inactive maculopathies.
• To determine if PAM accuracy is influenced by patient age, gender, preoperative visual acuity, or the specific type of maculopathy.

Main Methods:

• A prospective interventional clinical trial was conducted involving 57 patients scheduled for phacoemulsification.
• Preoperative and 1-month postoperative best-corrected visual acuity (BCVA), PAM testing, fluorescein angiography, and macular optical coherence tomography were performed.
• Patients were categorized by preoperative BCVA and age groups. PAM accuracy was graded based on the difference between PAM prediction and postoperative BCVA.

Main Results:

• The study included 57 patients (mean age 71.05 years; 34 females) with diabetic maculopathy (36.84%) or age-related macular degeneration (63.16%).
• The mean preoperative BCVA was 0.198, mean PAM score was 0.442, and mean postoperative BCVA was 0.435.
• PAM accuracy was high, with Grade 1, 2, and 3 errors occurring in 80.7%, 94.7%, and 98.2% of cases, respectively. A significant correlation was found between PAM score and postoperative BCVA (P < 0.001).
• PAM test accuracy showed no correlation with age, gender, diagnosis, or preoperative BCVA.

Conclusions:

• The Potential Acuity Meter (PAM) demonstrates high accuracy in predicting postoperative visual acuity in patients undergoing cataract surgery, particularly those with Grade I and II nuclear cataracts and inactive maculopathies.
• PAM serves as a valuable tool for ophthalmologists to set realistic visual expectations for patients with cataracts and coexisting macular conditions.
• The study supports the use of PAM as a reliable preoperative assessment method for visual potential in this patient population.