Abstract
Purpose :
Cataract surgery associated with amblyopia can be challenging as there is an increased risk of operative complications and postoperative refractive surprise (as amblyopic eyes may be smaller or larger than other eyes), uncertain visual potential in the amblyopic eye and there is a risk of postoperative diplopia reported in the literature. Several factors may contribute to fixation switch diplopia, including surgical eye sequence, delay between surgeries and target refraction. The aim of this study was to review one year of cataract surgery in amblyopic patients at Moorfields Eye Hospital, Bedford, to assess visual potential and complications in this patient group.
Methods :
Data from 42 consecutive patients who underwent bilateral phacoemulsification with known amblyopia was extracted retrospectively for cases between March 2018 and March 2019 with target refraction of emmetropia for both eyes. Parameters analysed included: preoperative and postoperative refractive status, preoperative and postoperative visual acuity (logMAR, best corrected and pinhole), presence/absence of diplopia, type of amblyopia (anisometropic, strabismic, visual deprivation), need for extra intervention/surgery, interval between surgery to fellow eye and eye sequence (dominant vs non-dominant first).
Results :
The amblyopic eye was operated on first in 72% of cases, and no cases of postoperative diplopia were identified.
Conclusions :
This study found no evidence for an increased risk of diplopia postoperatively. Visual acuity in the amblyopic eye can improve considerably after cataract surgery which is often 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.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.