Abstract
Purpose :
The flash VEP test has emerged as the most valuable tool for foreseeing postoperative visual acuity outcomes, owing to its diminished susceptibility to the media opacity of mature cataracts. This study aims to assess the effectiveness of the preoperative flash visual evoked potential (VEP) test in predicting postoperative visual acuity for monocular mature cataract cases when compared to the contralateral normal eye.
Methods :
The study included 60 patients, each with a monocular mature cataract diagnosis, who underwent preoperative flash VEP testing showing no pattern VEP response. Subsequently, phacoemulsification was performed. The Reti-Port® Scan21 Beta plus (Roland Consult Inc., Brandenburg, Germany) LED-based simulation equipment was used for conduction VEP test before and after cataract surgery. The relationship between the flash VEP test latency factors (P1, N2, P2) and amplitude factor (N2-P2), and the degree of visual acuity recovery three months post-cataract surgery, was evaluated using the LogMAR scale. Furthermore, a linear regression analysis was conducted to explore the connection between preoperative flash VEP components and postoperative visual acuity.
Results :
A total of 60 patients were included in this study, with a mean age of 65.4 ± 13.6 years (range: 43-87 years). The mean preoperative maximal-corrected LogMAR visual acuity was 1.70 ± 0.41 (range: 0.7-2.0). A significant disparity in visual acuity was observed between the preoperative and three-month postoperative stages (p < 0.001). The preoperative flash VEP test for mature cataracts revealed significant delays in P1, N2, and P2 latency, as well as a reduction in N2-P2 amplitude potential when compared to the contralateral normal eye (p < 0.001). Notably, delayed P2 latency and reduced N2-P2 amplitude potential were particularly indicative of poor visual acuity prognosis after cataract surgery in the multiple regression analysis (p < 0.05). The N2-P2 amplitude potential was the important factor that exhibited statistically significant results, with an area under the curve (AUC) of 80% sensitivity and 88% specificity, using a cutoff value of 6.07 μV.
Conclusions :
In cases of monocular mature cataract, a reduction in N2-P2 amplitude potential compared to the contralateral normal eye emerged as the most reliable predictor of postoperative visual prognosis following cataract surgery.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.