Abstract
Purpose :
Cataracts are a leading cause of vision impairment and cataract surgery is one of the most common procedures worldwide. The time between initial cataract evaluation and preoperative visit is variable in length and may be accompanied by changes in visual acuity (VA). This study quantifies the change in best visual acuity (BVA) over the preoperative period and assesses factors associated with postoperative outcomes.
Methods :
This was a retrospective review of patients who underwent cataract surgery at the Cleveland Clinic and had a preoperative assessment 0-30 days prior to surgery. Baseline demographic, past medical, and clinical data were collected through electronic medical record query. BVA was noted at initial surgical evaluation, preoperative visit, and nearest postoperative visit. Average BVA was compared using paired T-tests at each visit; single and multiple linear regressions were used to assess the effect of time between initial evaluation and surgery on outcomes.
Results :
742 patients (912 eyes) were included with a mean baseline age of 69.8 +10.4. Mean BVA at the initial evaluation, preoperative, and postoperative visits was 64.8±17.4, 64.2±18.9, and 81.0±12.1 letters respectively. Mean BVA was significantly higher at the post-op appointment compared to the pre-op appointment and initial evaluation (p < 0.0001) (Figure 1). There was an average of 42 and 54 days between initial evaluation and the preoperative and surgery dates respectively. VA worsened by <3 lines in 9.4% of patients and improved by >3 lines in 6.4% in the preoperative period. Time-to-surgery was significantly associated with change in BVA after surgery (effect size= -0.03 letters, p=0.015) on simple regression, but was not significant in the multiple regression; BVA at initial evaluation, glaucoma surgery, glaucoma, and hyperlipidemia were significantly associated with postoperative outcomes on multiple regression (Table 1).
Conclusions :
The majority of eyes experience stable vision in the preoperative period for cataract surgery. One limitation may be the relatively small proportion of eyes experiencing greater than 60 days between initial evaluation and surgery (n=298), which may be underpowered to detect significant differences in preoperative vision changes secondary to surgical delays.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.