Relationship cataract density and visual field damage

In interpreting visual field results, two questions arise: a) what type of visual field damage is produced by cataract, and b) can the influence on the visual field somehow be predicted? To answer these questions, cataract density was quantified with the Opacity Lens Meter (OLM) 701, and visual field tests were done before and after IOL-implantation surgery with Octopus Program G1 in 58 eyes of 58 patients (mean age 71 +/- 8 years) with cataract but with no other detectable ocular diseases. The average improvement of mean damage (MD) after surgery was 5.4 dB, and that of D (20) (defect 20 on the Bebie Curve) was 5.7 dB. The improvement of the visual fields was, as expected, statistically highly significant (p < 0.0001). The corrected loss variance (CLV), however, increased on the average only by 2.5 dB2, which was not significant. The predictive value of the OLM reading for opacity-induced MD depends on the type of cataract. It is good for cortical and nuclear cataracts but poor for posterior subcapsular opacifications. The overall predictive value (R = 0.66) is, nevertheless, better than for preoperative visual acuity (R = -0.54). If OLM and visual acuity (VA) are considered together, the predictive value is slightly higher (R = 0.72). Thus, optical density influences on visual field performance can be subtracted from general visual field results.