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R. A. Harrad, D. Tole, J. Waterfall; The Outcome of Cataract Surgery in Amblyopia. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2831. doi: https://doi.org/.
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There is no published data regarding the outcome of cataract surgery on amblyopic eyes (Hale et al Br J Ophthalmol 2006). There are an estimated 4,500 cases per year in UK. Recent work shows amblyopic eyes may be highly sensitive to cataract-induced blur despite poor visual acuity (Simmers et al IOVS 2003).
Retrospective audit of Bristol Eye Hospital case notes and Electronic Patient Record (EPR) entries from Sept 2003 - Feb 2007, yielded 61 adults with strong documentary evidence of unilateral amblyopia. Co-pathologies, pre-operative symptoms, pre-and post-operative acuities, operative complications and time between 1st and 2nd eye surgery were recorded and compared with the UK EPR Audit and Bristol EPR Audit 2003-2007.
Pre-operative blur was reported in 36.1% amblyopic eyes v 19.4% fellow eyes.White cataract was found in 11.5% amblyopic eyes v 3% Bristol EPR (p=0.003).Serious operative complications: 6.5% amblyopic eyes v 1.6 % Bristol EPR (p<0.05).75% complications in amblyopic eyes were associated with white cataract.The increase in percentage of patients with VA 6/12 or better post-operatively was 43% in amblyopic eyes v 50% Bristol EPR.Time between 1st & 2nd eye cataract surgery(Fellow eye 1st) 93 - 5204 days for amblyopic patients v Bristol EPR: 0-827 days (p=0.0009).
Amblyopic eyes are sensitive to blur. Visual acuity in the amblyopic eye can improve considerably after cataract surgery which is often, perhaps inappropriately, delayed, leading to an increased risk of complications associated with dense cataract. Operating earlier would relieve symptoms such as blur and avoid potentially difficult surgery. To our knowledge this is the first study to address this common clinical condition.
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