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Cheng KK, Anderson MJ, Velissaris S, Moreton R, Al-Mansour A, Sanders R, Sutherland S, Wilson P, Blaikie A. Cataract risk stratification and prioritisation protocol in the COVID-19 era. BMC Health Serv Res 2021; 21:153. [PMID: 33596884 PMCID: PMC7887562 DOI: 10.1186/s12913-021-06165-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/09/2021] [Indexed: 12/28/2022] Open
Abstract
Background The COVID-19 pandemic halted non-emergency surgery across Scotland. Measures to mitigate the risks of transmitting COVID-19 are creating significant challenges to restarting all surgical services safely. We describe the development of a risk stratification tool to prioritise patients for cataract surgery taking account both specific risk factors for poor outcome from COVID-19 infection as well as surgical ‘need’. In addition we report the demographics and comorbidities of patients on our waiting list. Methods A prospective case review of electronic records was performed. A risk stratification tool was developed based on review of available literature on systemic risk factors for poor outcome from COVID-19 infection as well as a surgical ‘need’ score. Scores derived from the tool were used to generate 6 risk profile groups to allow prioritised allocation of surgery. Results There were 744 patients awaiting cataract surgery of which 66 (8.9 %) patients were ‘shielding’. One hundred and thirty-two (19.5 %) patients had no systemic comorbidities, 218 (32.1 %) patients had 1 relevant systemic comorbidity and 316 (46.5 %) patients had 2 or more comorbidities. Five hundred and ninety patients (88.7 %) did not have significant ocular comorbidities. Using the risk stratification tool, 171 (23 %) patients were allocated in the highest 3 priority stages. Given an aging cohort with associated increase in number of systemic comorbidities, the majority of patients were in the lower priority stages 4 to 6. Conclusions COVID-19 has created an urgent challenge to deal safely with cataract surgery waiting lists. This has driven the need for a prompt and pragmatic change to the way we assess risks and benefits of a previously regarded as low-risk intervention. This is further complicated by the majority of patients awaiting cataract surgery being elderly with comorbidities and at higher risk of mortality related to COVID-19. We present a pragmatic method of risk stratifying patients on waiting lists, blending an evidence-based objective assessment of risk and patient need combined with an element of shared decision-making. This has facilitated safe and successful restarting of our cataract service.
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Affiliation(s)
- Kelvin Kw Cheng
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.
| | - Martin J Anderson
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK
| | - Stavros Velissaris
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK
| | - Robert Moreton
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.,University of Edinburgh, Edinburgh, UK
| | - Ahmed Al-Mansour
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK
| | - Roshini Sanders
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.,University of Edinburgh, Edinburgh, UK
| | - Shona Sutherland
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK
| | - Peter Wilson
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK
| | - Andrew Blaikie
- Ophthalmology Department, NHS Fife, Queen Margaret Hospital, Fife, Dunfermline, UK.,University of St Andrews, St. Andrews, UK
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Westborg I, Albrecht S, Granstam E, Karlsson N, Kugelberg M, Lundström M, Montan P, Behndig A. Treatment of age-related macular degeneration after cataract surgery: a study from the Swedish National Cataract and Macula Registers. Acta Ophthalmol 2021; 99:e124-e129. [PMID: 32573070 DOI: 10.1111/aos.14519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/26/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE To characterize pre- and perioperative factors associated with treatment for wet age-related macular degeneration (wet AMD) after cataract surgery. METHODS This register-based cohort study with data from the Swedish National Cataract Register (NCR) and the Swedish Macula Register (SMR) from 2010 to 2017 compared eyes with and without preoperative AMD that had undergone cataract surgery and was subsequently treated for wet AMD to eyes not treated within the study period. All first-eye surgeries registered in the NCR from 2010 to 2017 and matching eyes found in the SMR that had undergone treatment for wet AMD ≥ 1 year after the cataract procedure were included. Data for cataract surgery date, age and gender, use of a blue-blocking IOL, preoperative visual acuity, ocular comorbidities, posterior capsule rupture and date of AMD treatment initiation were extracted. RESULTS The only independent factor associated with postoperative treatment of wet AMD in both groups was female gender (67.3% vs. 58.8%, p < 0.001 and 66.4% vs. 60.6%, p = 0.001, respectively). Older age was an independent factor in eyes without preoperative AMD (78.4 ± 6.5 vs. 73.4 ± 9.6 years, p < 0.001). A blue-blocking IOL appeared to decrease the likelihood of subsequent wet AMD treatment slightly but not statistically significant in eyes with preoperative AMD (52.7% vs. 56.8%, p = 0.110). CONCLUSIONS Some factors (female gender, high age) are associated with undergoing subsequent treatment for wet AMD to a higher extent. If the use of a blue-blocking IOL offers any protection from undergoing AMD treatment after cataract surgery, such an effect must be very small.
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Affiliation(s)
- Inger Westborg
- Department of Clinical Sciences/Ophthalmology Umeå University Hospital Umeå Sweden
| | | | | | | | | | - Mats Lundström
- Department of Clinical Sciences Ophthalmology Faculty of Medicine Lund University Lund Sweden
| | - Per Montan
- St. Erik Eye HospitalKarolinska Institutet Stockholm Sweden
| | - Anders Behndig
- Department of Clinical Sciences/Ophthalmology Umeå University Hospital Umeå Sweden
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3
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Guliani BP, Agarwal I, Naik MP. Effect of Uncomplicated Cataract Surgery on Central Macular Thickness in Diabetic and Non-diabetic Subjects. J Ophthalmic Vis Res 2019; 14:442-447. [PMID: 31875099 PMCID: PMC6825692 DOI: 10.18502/jovr.v14i4.5447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 03/24/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the quantitative changes of macula in diabetic and non-diabetic eyes after uncomplicated cataract surgery. Methods In this prospective interventional study being performed in a tertiary healthcare hospital, a total of 660 eyes were divided into two groups. Group 1 included 330 eyes from healthy subjects and group 2 included 330 eyes from well-controlled diabetic subjects with no diabetic retinopathy planned for phacoemulsification with foldable IOL implantation by the same surgeon under similar settings. Optical Coherence Tomography (Heidelberg Spectralis SD-OCT) was used to assess preoperative and postoperative central macular thickness (CMT) at weeks 1 and 6. Results The mean CMT in group 1 preoperatively, at postoperative week 1, and at post-operative week 6 was 257.03 ± 20.904, 262.82 ± 17.010, and 265.15 ± 20.078 µm, respectively. The corresponding values in group 2 were 255.36 ± 17.852, 259.15 ± 16.644, and 266.09 ± 18.844 µm, respectively. There was no significant difference in the mean CMT values between the two groups on any of the three occasions when the CMT was measured (P = 0.374 and P = 0.313 at weeks 1 and 6, respectively). Conclusion There was no statistically significant difference in CMT between normal subjects and diabetic subjects without diabetic retinopathy preoperatively and in early postoperative period after uncomplicated phacoemulsification surgery.
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Affiliation(s)
- Brahm Prakash Guliani
- Department of Ophthalmology, Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Isha Agarwal
- Department of Ophthalmology, Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Mayuresh P Naik
- Department of Ophthalmology, Hamdard Institute of Medical Sciences & Research, Hakeem Abdul Hameed Centenary Hospital, New Delhi, India
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Cox JT, Subburaman GBB, Munoz B, Friedman DS, Ravindran RD. Visual Acuity Outcomes after Cataract Surgery. Ophthalmology 2019; 126:1480-1489. [DOI: 10.1016/j.ophtha.2019.03.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 03/13/2019] [Accepted: 03/22/2019] [Indexed: 11/24/2022] Open
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Ganesh S, Brar S, Sreenath R. Immediate sequential bilateral cataract surgery: A 5-year retrospective analysis of 2470 eyes from a tertiary care eye center in South India. Indian J Ophthalmol 2017; 65:358-364. [PMID: 28573990 PMCID: PMC5489653 DOI: 10.4103/ijo.ijo_947_16] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: The purpose of this study is to evaluate the safety and benefits of immediate sequential bilateral cataract surgery. Patients and Methods: Retrospective data analysis of patients who underwent immediate sequential bilateral phacoemulsification with foldable intraocular lens (IOL) implantation under topical anesthesia from January 2011 to September 2016 was performed. Patients with visually significant bilateral cataract within the axial length range of 21.0–26.5 mm were included in the study. Intraoperative and postoperative complications were evaluated. Results: Two thousand four hundred and seventy eyes from 1235 patients with a mean age of 68.34 years (range: 4–90 years) were analyzed. Best-corrected visual acuity improved from 0.40 ± 0.17 to 0.08 ± 0.10 (logarithm of the minimum angle of resolution). Nearly 92.05% eyes achieved a target postoperative refraction of ± 0.5 D spherical equivalent. Main complications observed were prolonged postoperative inflammation in 25% (n = 31), posterior capsular tears in 0.45% (n = 11), and unilateral cystoid macular edema in 0.08% (n = 2) eyes. No sight-threatening complications such as endophthalmitis, retinal detachment, corneal decompensation and intraocular hemorrhage occurred in any of the eyes. Out of the 288 (23.2%) patients who underwent bilateral multifocal IOL implantation, 23 patients (46 eyes) had femtolaser-assisted cataract surgery procedure. Two pediatric and one Downs syndrome patient underwent bilateral cataract surgery under general anesthesia and intravenous sedation, respectively. Conclusion: IBSCS may be considered as a preferred practice in eligible cases considering significant patient benefits such as early visual rehabilitation, time and cost-effectiveness, and better compliance with postoperative medications. In debilitated patients and special situations, such as pediatric cataract and Downs syndrome requiring general anesthesia it may be the ideal procedure.
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Affiliation(s)
- Sri Ganesh
- Department of Phaco and Refractive, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Sheetal Brar
- Department of Phaco and Refractive, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
| | - Rohit Sreenath
- Department of Phaco and Refractive, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
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Ni W, Li X, Hou Z, Zhang H, Qiu W, Wang W. Impact of cataract surgery on vision-related life performances: the usefulness of Real-Life Vision Test for cataract surgery outcomes evaluation. Eye (Lond) 2015; 29:1545-54. [PMID: 26272444 DOI: 10.1038/eye.2015.147] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 06/29/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Real-Life Vision Test (RLVT) is a newly developed performance-based measures of functional vision. This present study is designed to determine whether it could be a meaningful assessment for cataract surgery outcomes evaluation. PATIENTS AND METHODS Age-related cataract patients (56) who scheduled for bilateral cataract surgery and 44 age-matched controls were evaluated by four types of measurements: (1) demographic, medical, cognitive and depressive evaluation, and the reaction time testing; (2) clinical measures (visual acuity, contrast sensitivity, stereopsis, and color perception); (3) the 25-item National Eye Institute's Visual Functioning Questionnaire (NEI-VFQ); (4) the RLVT. Spearman's coefficients and multiple regression analysis were conducted to investigate the relationship among RLVT, clinical measures, and self-report assessment of visual function. RESULTS The results of RLVT, clinical measures, and NEI-VFQ total scores were improved significantly after cataract surgery. There were no differences between control subjects and post-surgery patients with respect to NEI-VFQ-25 total scores, self-rating depression scale scores and three tasks of RLVT. Change of RLVT was significantly associated with the change of clinical measures in the cataract group. Multiple regression analysis demonstrated that change of distance, intermediate, and near visual acuity, and binocular contrast sensitivity were significant predictors of improvements of RLVT. CONCLUSIONS Cataract surgery could improve real-world visual ability effectively for cataract patients. Our study highlights the potential usefulness of RLVT as an adjunct to the current outcomes evaluation system for cataract surgery. The use of RLVT combined with clinical and self-survey methods may be the comprehensive strategy to manifest the impact of cataract surgery on patients' overall vision-related quality of life.
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Affiliation(s)
- W Ni
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China
| | - X Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China
| | - Z Hou
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China
| | - H Zhang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - W Qiu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China
| | - W Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China.,Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China
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Lai FHP, Lok JYC, Chow PPC, Young AL. Clinical outcomes of cataract surgery in very elderly adults. J Am Geriatr Soc 2013; 62:165-70. [PMID: 24279708 DOI: 10.1111/jgs.12590] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the clinical outcomes of cataract surgery elderly adults. DESIGN Retrospective cohort study. SETTING Two clustered hospitals. PARTICIPANTS Two hundred seven individuals aged 90 and older who underwent cataract surgery for primary senile cataracts. MEASUREMENTS Best-corrected preoperative and postoperative Snellen visual acuity, type of cataract, surgical techniques, preoperative systemic or ocular comorbidities, and intraoperative and postoperative complications were assessed. Improvement of visual acuity was defined as a decrease in logMAR acuity of 0.1. Factors associated with visual outcome within 6 months after surgery were identified using logistic regression modeling. The duration of postoperative survival was calculated. RESULTS In the 207 participants (mean age 92.0 ± 2.1), 79.7% achieved visual improvement after cataract surgery. Forty-eight percent (mean age 97.4 ± 2.8) were alive on December 31, 2012. The most common systemic comorbidities were hypertension (66.2%), diabetes mellitus (25.1%), and myocardial infarction (19.8%). Age-related macular degeneration (AMRD) (15.9%), glaucoma (10.6%), and myopic degeneration (5.3%) were the three most common ocular comorbidities. Uncomplicated cataract surgery was performed in 87.0% cases. The most common complications were vitreous loss (8.2%), posterior capsular rupture (7.2%), and zonular rupture (4.8%). Participants with AMRD (P = .001, odds ratio (OR) = 4.77, 95% confidence interval (CI) = 1.86-12.26) and vitreous loss (P = .001, OR = 12.86, 95% CI = 2.71-61.10) were less likely to achieve postoperative visual improvement. CONCLUSION Despite a high prevalence of systemic and ocular comorbidities in very elderly adults, good clinical outcomes of cataract surgery were attainable. ARMD and vitreous loss were associated with a lower chance of postoperative visual improvement.
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Affiliation(s)
- Frank H P Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
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8
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Lobo C. Pseudophakic Cystoid Macular Edema. Ophthalmologica 2012; 227:61-7. [DOI: 10.1159/000331277] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 07/29/2011] [Indexed: 11/19/2022]
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9
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Charalampidou S, Nolan J, Loughman J, Stack J, Higgins G, Cassidy L, Beatty S. Psychophysical impact and optical and morphological characteristics of symptomatic non-advanced cataract. Eye (Lond) 2011; 25:1147-54. [PMID: 21660066 DOI: 10.1038/eye.2011.123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To investigate whether psychophysical, morphological, and/or optical characteristics of symptomatic non-advanced cataract are complementary to, or more appropriate than, visual acuity (VA) for the purposes of recording visual data that reflect subjective visual difficulty in patients with cataract that exhibit relative sparing of high contrast acuity (0.4 logarithm of minimal angle of resolution (logMAR) scale or better). METHODS Eighty-two patients with symptomatic non-advanced cataract and no other ocular pathology were asked to complete a validated questionnaire, and to perform a series of visual function assessments including: corrected distance VA (CDVA); photopic and mesopic contrast sensitivity; photopic and mesopic glare disability (GD); reading acuity and reading speed; stereoacuity; and retinal sensitivity. Optical and morphological characteristics of the cataract were evaluated by lens optical density and by the Lens Opacities Classification System III, respectively. Correlations between questionnaire score and each of these measures were calculated. RESULTS Statistically significant negative correlations were observed between the Rasch-scaled questionnaire score and mesopic GD (at 3 and 6 cycles per degree (cpd); r=-0.396 (P<0.01) and -0.451 (P<0.05), respectively) and between the Rasch-scaled questionnaire score and photopic GD (at 3 and 6 cpd; r=-0.328 (P<0.01) and -0.440 (P<0.01), respectively). CONCLUSION Symptomatic non-advanced cataract, in the presence of good CDVA, is associated with measurable subjective visual difficulty, best reflected in a decrease in mesopic and photopic GD (at medium spatial frequencies). CDVA does not reflect the patient's visual dissatisfaction in such cases.
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Affiliation(s)
- S Charalampidou
- Institute of Eye Surgery, Whitfield Clinic, Waterford, Ireland.
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Sjöstrand J, Laatikainen L, Hirvelä H, Popovic Z, Jonsson R. The decline in visual acuity in elderly people with healthy eyes or eyes with early age-related maculopathy in two Scandinavian population samples. Acta Ophthalmol 2011; 89:116-23. [PMID: 19845558 DOI: 10.1111/j.1755-3768.2009.01653.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to analyse the decline in visual acuity (VA) during normal ageing in two Scandinavian population samples of subjects aged ≥ 70 years and to study the age-specific decline in VA in eyes with early age-related maculopathy (ARM). METHODS We carried out a cross-sectional analysis of data pertaining to VA in the better eye in one population sample from Oulu (OU), Finland (aged 70-82 years) and a second population sample from Gothenburg (GG), Sweden (aged 82 or 88 years). The change in VA with age was evaluated in healthy eyes (OU, n = 119; GG, n = 40) and in eyes with early ARM (OU-ARM, n = 22; GG-ARM, n = 114) using linear regression or logistic regression. The results were compared with those of previous reports. RESULTS Our population samples showed a significant decrease with age in VA in healthy eyes in subjects aged ≥ 44 years using both statistical models. Comparisons with previous reports demonstrated a homogeneity in the decline in VA with age. On average, 0.3 logMAR are lost from middle age up to 88 years, presumably as a result of physiological ageing. In early ARM, the rate of age-specific decline in VA more than doubled and the prevalence of VA < 0.5 markedly increased. CONCLUSIONS Visual acuity in healthy eyes declines with age from middle age onwards. The decrease in VA possibly accelerates in subjects aged > 70 years, although no significant evidence for this was found. An age-specific decline in VA is shown in eyes with early ARM. These results are important for the evaluation of age-specific treatment results.
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Affiliation(s)
- Johan Sjöstrand
- Department of Ophthalmology, University of Gothenburg, Sweden.
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Kirkwood BJ, Hendicott PL, Read SA, Pesudovs K. Repeatability and validity of lens densitometry measured with Scheimpflug imaging. J Cataract Refract Surg 2009; 35:1210-5. [PMID: 19545810 DOI: 10.1016/j.jcrs.2009.03.017] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Revised: 03/25/2009] [Accepted: 03/26/2009] [Indexed: 11/17/2022]
Abstract
PURPOSE To assess the repeatability and validity of lens densitometry derived from the Pentacam Scheimpflug imaging system. SETTING Eye Clinic, Queensland University of Technology, Brisbane, Australia. METHODS This prospective cross-sectional study evaluated 1 eye of subjects with or without cataract. Scheimpflug measurements and slitlamp and retroillumination photographs were taken through a dilated pupil. Lenses were graded with the Lens Opacities Classification System III. Intraobserver and interobserver reliability of 3 observers performing 3 repeated Scheimpflug lens densitometry measurements each was assessed. Three lens densitometry metrics were evaluated: linear, for which a line was drawn through the visual axis and a mean lens densitometry value given; peak, which is the point at which lens densitometry is greatest on the densitogram; 3-dimensional (3D), in which a fixed, circular 3.0 mm area of the lens is selected and a mean lens densitometry value given. Bland and Altman analysis of repeatability for multiple measures was applied; results were reported as the repeatability coefficient and relative repeatability (RR). RESULTS Twenty eyes were evaluated. Repeatability was high. Overall, interobserver repeatability was marginally lower than intraobserver repeatability. The peak was the least reliable metric (RR 37.31%) and 3D, the most reliable (RR 5.88%). Intraobserver and interobserver lens densitometry values in the cataract group were slightly less repeatable than in the noncataract group. CONCLUSION The intraobserver and interobserver repeatability of Scheimpflug lens densitometry was high in eyes with cataract and eyes without cataract, which supports the use of automated lens density scoring using the Scheimpflug system evaluated in the study.
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Affiliation(s)
- Bradley J Kirkwood
- School of Optometry, Queensland University of Technology, Brisbane, Australia.
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Cugati S, Loryn TD, Pham T, Arnold J, Mitchell P, Wang JJ. Australian Prospective Study of Cataract Surgery and Age-Related Macular Degeneration: Rationale and Methodology. Ophthalmic Epidemiol 2009; 14:408-14. [DOI: 10.1080/09286580701316124] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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