Ocular Dominance Shift in Refractive Cataract Surgery: A prospective, observational study.

Abstract

To explore the features of the dominant and non-dominant eyes in patients with cataracts and predict ocular dominance shift (ODS) based on preoperative indicators. and setting: This prospective, observational study was conducted in Changsha Aier Eye Hospital in Changsha, Hunan province, China. Patients with age-related cataracts who underwent unilateral cataract surgery were enrolled in this study. Before the procedure, uncorrected visual acuity (UCVA) was assessed, and non-cycloplegic subjective refraction evaluations were conducted to determine best-corrected visual acuity (BCVA). Total astigmatism, corneal astigmatism, and intraocular astigmatism were measured using OPD-Scan III. Cataract type was assessed using slit-lamp biomicroscopy based on the Lens Opacities Classification System III (LOCS III). Ocular dominance (OD) was determined under corrected conditions using the hole-in-card test. Follow-up visits occurred at 1 day, 1 week, and 1-month post-surgery. After 1 month, OD was re-evaluated, and participants completed the Catquest-9SF questionnaire. 94 patients (188 eyes) were enrolled in the study. The analysis showed that the ODS rate of unilateral cataract surgery was 40.4%. In addition, age, uncorrected visual acuity of non-dominant eye, posterior subcapsular cataract and total astigmatism are risk factors for ODS. Besides, no difference in vision-related quality of life was detected between patients who had ODS and those who did not. We identified several preoperative parameters as potential risk factors of ODS after cataract surgery. These findings provide guidance for predicting changes in the dominant eye, thus improve the precise selection of intraocular lenses and the implementation of monovision strategies.