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Ron Kaufman, Ori Saban, Jamie Levy, Shahar Luski, Itay Chowers, Hadas Ben-Eli; A Neurodegenerative Disease as a Risk Factor for a Poorer Visual Outcome After Cataract Extraction Surgery. Invest. Ophthalmol. Vis. Sci. 2020;61(7):814.
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© ARVO (1962-2015); The Authors (2016-present)
Neurodegenerative diseases (NDD), including Alzheimer’s and Parkinson’s diseases, are relatively common among individuals undergoing cataract extraction (CE). Limited data is available on the outcome of CE in NDD patients. This study aims to assess for potential interactions among NDD and the outcome of CE.
A retrospective analysis of all patients that underwent CE at Hadassah Medical Center between 2013-2018 was performed. Data collected included demographics, pre- and post-operative uncorrected (UCVA) and best corrected by Pinhole (BCVA) LogMAR visual acuity. Patients were then classified into 3 subsets: individual having the diagnosis of Alzheimer’s disease (AD) or Parkinson’s disease (PD), and ones without the diagnosis of AD or PD (NNDD). Statistical analysis was performed using ANOVA, Pearson Coefficient, χ2 test and multinomial regression models.
From an electronic medical records (EMR) dataset of 11,545 surgeries, 2,684 patients had complete information and were included in the analysis. The mean age was 69.8±14.6 years and 52% were males. The median UCVA of the entire database improved from 0.6 to 0.4 after surgery (P<0.001), while the median BCVA improved from 0.4 to 0.3 after surgery (P<0.001). Twenty-eight AD patients and 33 PD patients were identified in the database. The mean pre-operative logMAR UCVA was similar across the groups (AD 1.38±0.96, PD 0.87±0.67, NNDD 0.98±1.0; P=0.28), as well as the mean pre-operative logMAR BCVA (AD 0.42±0.19, PD 0.43±0.21, NNDD 0.36±0.28; P=0.63). AD patients had poorer mean post-operative UCVA (1.31±1.1) compared to NNDD (0.67±0.86, P=0.001), with an odds ratio of 1.6 (95% CI: 1.12-2.27, P=0.009) to a worse post-operative UCVA than NNDD patients. On the other hand, PD patients (0.49±0.41) had a similar outcome as NNDD (P=0.32). Final BCVA was similar across NNDD (0.33±0.27), AD (0.40±0.22) and PD (0.28±0.22) patients (P=0.76).
Patients with AD and PD enjoy a mean improvement in visual acuity following CE. AD is potentially associated with lower UCVA but similar BCVA compared to PD and NNDD following CE. Technical difficulties in the biometry measurements or the surgical procedure due to poor cooperation of AD patients might underlie the lower final UCVA in AD.
This is a 2020 ARVO Annual Meeting abstract.
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