Predictions of outcomes from cataract surgery in elderly persons

To determine how well visual outcomes of cataract surgery can be predicted from acuity estimations by visual instruments and an ophthalmologist, the authors compared predictions of postsurgical visual acuity with the measured acuity at 4 months in 82 elderly persons. Comparisons were made between the potential acuity meter (PAM), laser interferometer (LI), and an ophthalmologist, who predicted the final vision before surgery using screening visual information, including PAM, LI data, and results of the patient's examination. Neither instrument alone was successful in predicting postsurgical acuity +/- 1 contiguous Snellen chart line (bivariate correlation [r] = 0.03 for PAM and 0.07 for LI). The ophthalmologist was the most accurate predictor of acuity within 1 line (r = 0.41, p less than or equal to 0.001). These results indicate that the PAM and LI did not independently predict postsurgical vision in elderly cataract patients, but results of a clinical examination markedly improved the accuracy of predictions.