Abstract
Purpose To determine the effects of cataract surgery on contrast visual acuity and retinal sensitivity in patients with retinitis pigmentosa. Methods Retinal sensitivity and contrast visual acuity were determined by microperimetry (MAIA) and contrast sensitivity acuity tester (CAT-CP), respectively, before and after cataract surgery. The significance of the correlations between visual acuity, retinal sensitivity, contrast visual acuity, improvements after surgery, and macular structure before and after cataract surgery was determined. Results Retinal sensitivity and contrast visual acuity were significantly improved after cataract surgery. The correlations among postoperative visual acuity, postoperative retinal sensitivities, and preoperative ellipsoid zone length were significant. The postoperative retinal sensitivity of the central 10° and the ellipsoid zone length was particularly significantly correlated. Preoperative contrast visual acuity and the amount of improvement and preoperative retinal sensitivity and the amount of improvement were significantly negatively correlated. The contrast visual acuity under both the 100% and 10% photopic and mesopic conditions improved significantly after cataract surgery. Conclusions Cataract surgery in retinitis pigmentosa patients with preserved ellipsoid zones significantly improved retinal sensitivity and contrast visual acuity. Cataract surgery can be expected to improve retinal sensitivity and contrast visual acuity under various conditions, even if preoperative visual parameters are low, as long as the ellipsoid zone is preserved.
Highlights
Cataracts are common complications in all hereditary forms of retinitis pigmentosa (RP) [1]
We evaluated the effect of cataract surgery on best corrected visual acuity (BCVA) in RP patients
It remains unclear whether macular staphyloma and changes in the curvature are associated with the progression of retinal degeneration. e reason for the positive correlation between axial length (AL) and postoperative BCVA found in this study is unclear, but recently, Meinert et al reported that the macular curvature in RP eyes becomes more concave in eyes with preserved ellipsoid zone (EZ) width at >2000 μm [19]
Summary
Cataracts are common complications in all hereditary forms of retinitis pigmentosa (RP) [1]. Cataracts develop at a relatively young age in RP patients [2, 3] and, impact patients’ quality of life due to the loss of visual function. It is occasionally difficult to judge whether cataract surgery is beneficial for patients with RP because of problems such as fragile Zinn’s zonular fibers, posterior capsular opacification, anterior capsular contraction, macular edema, and difficulty in predicting postoperative visual function. Earlier studies have shown that the findings obtained with the Humphrey Visual Field Analyzer (HFA) and optical coherence tomography (OCT) are important for predicting the visual outcome of cataract surgery in patients with RP [5, 6]. Retinal sensitivity determined by microperimetry and contrast visual acuity (CVA) under different lighting conditions such as photopic and mesopic background are factors of importance in daily life in patients with RP. Even though it is necessary to know the impact of cataract surgery on these parameters, no previous study has performed a detailed analysis and correlation between CVA, retinal sensitivity, and the amount of improvement before and after cataract surgery in RP patients
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