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Identifier

000382603

Title

Αξιολόγηση της φωτεινής ευαισθησίας της ωχράς και της σταθερότητας προσήλωσης σε ασθενείς που υποβάλλονται σε χειρουργείο καταρράκτη

Alternative Title

Macular light sensitivity and fixation stability in patients undergoing cataract surgery

Author

Λιακόπουλος, Δημήτριος Α

Thesis advisor

Παλλήκαρης, Ιωάννης

Reviewer

Τσιλιμπάρης, Ιωάννης
Κυμιωνής, Γεώργιος

Abstract

Purpose: The evaluation of macular light sensitivity and fixation stability in patients with age-related cataract before and after phacoemulsification cataract surgery. Patients and Methods: In a prospective, interventional design, 24 eyes (23 patients, 14 male and 9 female) were recruited. There was performed preoperative and postoperative evaluation of best corrected visual acuity using logMAR EDTRS UoC chart, macular light sensitivity and fixation stability using microperimeter MAIA (Macular Integrity Assessment, Centervue Inc., Padova, Italy). Cataract was categorized and graded using the Lens Opacities Classification System (LOCS III). Results: The preoperative best corrected visual acuity (BCVA) and average threshold sensitivity (Av. Threshold) was 0.37 logMAR and 23.39 dB, respectively and improved to 0.09 logMAR (p ΄&λτ.001) and 27.58 dB (p ΄&λτ.001) respectively at 2 weeks and 0.03 logMAR (p ΄&λλτ.001) and 28.89 dB (p΄&λτ.001), respectively at 4 weeks postoperatively. The BCVA and Av.Threshold was significantly correlated at all time interval (p=0.001). The BCVA showed a statistically significant correlation with posterior subcapsular cataract (LOCS III) in the preoperative results (p = 0.003) and with the improvement of BCVA at 2 and 4 weeks (p = 0.048, p = 0.005). The Av.Threshold sensitivity showed statistically significant correlation with all types of cataract (LOCS III) preoperatively (p = 0.033), but remained significant for the NC parameter of nuclear cataract (p = 0.019, p = 0.006) and the posterior subcapsular cataract (p = 0.007, p ΄&λτ0.001) compared to the improvement of Av.Threshold at 2 and 4 weeks postoperatively. According to the empirical cataract classification system statistically significant differences found in the preoperative BCVA between stages I-III (p = 0.042) and I-IV (p = 0.011) posterior subcapsular cataract, in the improvement of the BCVA at 2 weeks between stages I -II (p = 0.011) of the nuclear cataract and at 4 weeks BCVA improvement between the stages I-IV (p = 0.011) of the posterior subcapsular cataract. GLM model applied on the results of preoperative Av.Threshold and showed the effect of 9 the nuclear cataract with significant differences between the stage II-III (p = 0.012) and the posterior subcapsular cataract with significant differences between stages I-III (p = 0.004), I-IV (p = 0.016), II-IV (p = 0.046) and II-III (p = 0.027). The improvement of Av.Threshold at 2 weeks showed a difference between the stages I-IV (p = 0.011), while no significant difference was shown at 4 weeks in the improvement of the Av.Threshold for the different stages in the three types of cataracts. As far as the fixation stability is concerned, the ellipse that includes the 63% and 95% of the fixation points increased after the cataract surgery. At 2 weeks postoperatively, 6 patients showed relatively unstable fixation although they had stable fixation preoperatively and at 4 weeks postoperatively, 5 patients showed relatively unstable fixation although they had stable preoperatively. Conclusion: The type and density of cataracts seem to affect the macular light sensitivity. The BCVA showed significant correlation with posterior subcapsular cataract, but did not show the same for nuclear and cortical cataract (LOCS III). The Av.Threshold sensitivity seemed to have a significant correlation with all types of cataract in the preoperative evaluation, but significant correlation with the parameter NO of nuclear cataract (LOCS III) and posterior subcapsular cataract (LOCS III), taking into account the age factor. The empirical cataract classification system showed low reliability compared with BCVA and Average Thershold Sensitivity. The fixation stability showed unexpected decrease after surgery and this requires further research.

Language

Greek

Subject

Cataract

Fixation stability

Macular light sensitivity

Καταρράκτης

Σταθερότητα προσήλωσης

Φωτεινή ευαισθησίας ώχρας

Issue date

2014-01-22

Collection