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Associations between Macular Sensitivity and Fixation in Pseudophakic Children after Congenital Cataract Surgery

Wenwen He^1,2,3,4,5, Yu Du^1,2,3,4,5, Jifeng Yu⁶

¹Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.

Current Eye Research

|June 8, 2019

Insights

Macular sensitivity (MS) is reduced in pseudophakic children post-cataract surgery, particularly with poorer fixation stability. The difference in MS within and outside the preferred fixation region increases with longer axial length and unstable fixation.

Area of Science:

Ophthalmology
Pediatric Ophthalmology
Visual Neuroscience

Background:

Congenital cataracts require early surgical intervention, leading to pseudophakia.
Assessing visual function in pseudophakic children is crucial for understanding long-term outcomes.
Macular sensitivity and fixation stability are key indicators of visual performance.

Purpose of the Study:

To investigate the relationship between macular sensitivity (MS) and fixation stability in children with pseudophakia after congenital cataract surgery.
To compare MS in pseudophakic eyes with healthy phakic eyes.
To identify factors influencing MS differences within and outside the preferred fixation region.

Main Methods:

Cross-sectional study including 55 pseudophakic eyes and 28 healthy phakic eyes.
Macular Integrity Assessment microperimeter used to measure MS and fixation stability (95% bivariate contour ellipse area - BCEA).
Optical coherence tomography (OCT) employed for central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) measurements.

Main Results:

Pseudophakic eyes exhibited significantly lower overall MS compared to controls.
Worse MS was observed in pseudophakic eyes with unstable fixation.
The difference in MS within and outside the 95% BCEA (ΔMS) was greater in eyes with poorer fixation stability and longer axial length.

Conclusions:

Macular sensitivity is diminished in pseudophakic children with impaired fixation following congenital cataract surgery.
A significant difference exists in MS between the preferred fixation region and its surroundings in these children.
Axial length and fixation stability are significant determinants of the observed differences in macular sensitivity.

Read full analysis

Abstract:

Purpose: To investigate the associations between macular sensitivity (MS) and fixation in pseudophakic children after congenital cataract surgery.Materials and Methods: In total 55 pseudophakic eyes and 28 healthy phakic eyes were included in this cross-sectional study. MS and fixation stability in term of 95% bivariate contour ellipse area (BCEA) were assessed with a Macular Integrity Assessment microperimeter. Central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) was measured with optical coherence tomography. MS inside and outside the 95% BCEA was compared. Influencing factors for the difference in MS between the two regions (ΔMS) were assessed.Results: The overall MS was significantly lower in pseudophakic eyes than in the controls (P < .001). In the pseudophakic group, fixation stability was stable/relatively unstable/unstable in 69.1%/16.4%/14.5% of eyes, and their MS was 27.60 ± 2.56, 25.02 ± 3.82, and 20.50 ± 7.15 dB, respectively. The unstable subgroup had significantly worse MS than the stable subgroup (P < .001). Among pseudophakic eyes, the MS inside the 95% BCEA (fixation preferred region) was significantly greater than that outside this region (P = .048), and it was more correlated with BCVA than that of the entire macula. The ΔMS became greater in those pseudophakic eyes with worse fixation stability (P < .001) and longer axial length (P = .002). Backward stepwise multiple linear regression also revealed 95%BCEA and axial length had significant influences on ΔMS (R² = 0.289, P < .001).Conclusion: MS was lower in pseudophakic eyes with poor fixation. Macular sensitivity inside and outside the fixation preferred region was different in pseudophakic children after congenital cataract surgery, and this difference increased with longer axial length and poorer fixation.

Keywords:

Macular sensitivity axial length congenital cataract fixation stability pseudophakic

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