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K-MA Tuan, IL Bailey, BJ Dolan, AJ Flach; Visual Functions Assessment and Posterior Capsular Opacification . Invest. Ophthalmol. Vis. Sci. 2002;43(13):425.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Changes of the lens capsule are common after cataract surgery. Apart from visual acuity measurements, the visual consequences of posterior capsular opacification (PCO) has received very little attention. We have evaluated the results of a battery of visual function tests and examined their relationships with morphological changes. Methods:Subjects with different degrees of PCO severity were recruited. Age-matched subjects with IOL but without PCO served as controls. Visual functions measured were high and low visual acuity, Pelli-Robson Contrast Sensitivity and Rabin Small Letter Contrast Sensitivity (all tested with and without glare from the Brightness Acuity Tester), the Berkeley Glare Test and the SKILL(Smight-Kettlewell Institute Low Luminance) test. A modified NIH Visual Function Questionnaire (VFQ) was administered. After dilation, the appearance of intraocular lens and the capsule was recorded with digital photography. Results:All tests gave better correlation and sensitivity under glare condition. The Berkeley Glare Test showed best sensitivity and correlation with PCO severity, followed by LCVA with glare. The SKILL card also provides good discriminability, especially for early stage of PCO formation. The SLCS has good sensitivity but it can not be applied to moderate or severe PCO patients. The modified NIH-VFQ has similar sensitivity to the other tests, but is less well correlated to PCO severity by itself. However, the test questions designed for glare is a good indicator when combined with other tests. Results of visual functional tests can be combined to assess the visual impact from PCO severity. Conclusion:Subjective impressions and objective measurements of visual abilities correlate well with PCO severity. Results suggest that the best way to evaluate the impact of opacification is to test low contrast visual acuity or contrast sensitivity under conditions of glare. The advantage of the Berkeley Glare Test over LCVS with glare and the PRCS with glare is probably due to the glare source not being affected by patient manipulations. Modified NIH-VFQ could be a valuable indicator of the impact of PCO.
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