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J. R. Zelefsky, R. Ritch, C. Tello, J. M. Liebmann; Effect of Cataract Extraction on Paracentral Visual Field Loss in Eyes With Advanced Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1067.
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To investigate the effects of cataract surgery on visual field indices in the central ten degrees in patients with advanced glaucoma.
We reviewed the charts of all patients with glaucomatous visual field loss within 10 degrees of fixation who underwent uncomplicated cataract extraction, with or without concomitant trabeculectomy or trabeculectomy revision, during a two-year period. Those with reliable pre- and postoperative achromatic automated perimetry of the central ten degrees of visual field (Humphrey Perimeter, program 10-2) were enrolled. Visual field indices were assessed for change.
We enrolled 34 eyes of 32 patients (18 men, 14 women). Twenty-one eyes (61.8%) had a diagnosis of primary open angle glaucoma (POAG), 4 eyes (11.8%) had chronic angle closure glaucoma (CACG), 4 eyes (11.8%) had exfoliative glaucoma (XFG), 4 eyes (11.8%) had normal tension glaucoma (NTG), and 1 eye (2.9%) had combined mechanism glaucoma (CMG). Mean best corrected visual acuity (LogMar) was 0.5 preoperatively and 0.2 postoperatively. Preoperative and postoperative visual field mean deviation was unchanged (-14.53 ± 5.67 vs. -14.38 ± 5.67 dB (p=0.36)) and pattern standard deviation worsened (9.40 ± 2.56 vs. 10.00 ± 2.79 (p=0.03)). Foveal sensitivity was also unchanged (28.7 ± 4.4 vs. 29.2 ± 4.5 dB (p=0.20)).
Cataract extraction improves visual acuity in eyes with glaucoma associated with advanced central visual field loss, but does not alter mean deviation or foveal sensitivity. The ability to detect focal loss as defined by pattern standard deviation is minimally enhanced by cataract extraction.
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