Journal article
Aniseikonia Associated with Cataract Surgery and Its Impact on Post-Surgical Binocular Vision
Chinese Journal of Optometry and Visual Science [中华眼视光学与视觉科学杂志/#/中華眼視光學與視覺科學雜誌 Chung Hua Yen Shih Kuang Hsueh Yu Shih Chueh K'O Hsueh Tsa Chih]
25 Nov 2022
Abstract
Objective: To investigate the changes of anisotropia after bilateral cataract surgery and to analyze the influence of anisotropia on binocular vision after surgery.
Methods: A prospective clinical study. From January to November 2019, 73 patients (≥50 years old) who were scheduled to undergo bilateral cataract surgery were recruited at the Pennsylvania College of Optometry and Lewis LASIK Eye Clinic at Salisbury University. All subjects underwent anisotropia examination before surgery for the first eye and anisotropia and comprehensive binocular vision examination after surgery for the second eye. The comprehensive binocular vision examination program included stereopsis, eye position, fusional vergence, vergence flexibility, and convergence near point examination. The binocular vision status (normal binocular vision or abnormal binocular vision) of the subjects was determined according to the results of binocular vision examination. The proportion of clinically significant anisotropia (≥3%) before and after surgery was compared by McNemar's chi-square test. The Spearman test was used to analyze the correlation between anisotropia and anisometropia, binocular intraocular lens (IOL) power difference, and stereopsis. Logistic regression was used to analyze the effect of anisotropia on postoperative binocular vision status. The receiver operating characteristic (ROC) curve was used to determine the critical value of anisotropia that could predict whether there was abnormal binocular vision after surgery.
Results: The average follow-up time after surgery was 2 months. A total of 51 subjects were included, of whom 13 (25%) were diagnosed with non-strabismic binocular vision abnormalities after surgery, mainly convergence insufficiency in 11 (22%) cases. There was no significant difference in the proportion of clinically significant anisotropia after surgery compared with that before surgery ( χ2 =1.14, P =0.286). There was no correlation between preoperative, postoperative, and surgical anisotropia and anisometropia, binocular IOL power difference, and stereopsis. Logistic regression analysis showed that postoperative binocular vision abnormalities were correlated with preoperative ( OR = 1.46, P =0.047), postoperative ( OR =1.67, P =0.031), and surgical anisotropia ( OR =1.48, P =0.021). ROC curve analysis showed that surgical anisotropia showed the best area under the curve (AUC), with an AUC value of 0.74. When surgical anisotropia was >2.4%, its sensitivity and specificity for predicting postoperative binocular vision abnormality were the best, at 80.6% and 65.0%, respectively. The AUC values of preoperative and postoperative anisotropia were 0.68 and 0.66, respectively. When the critical values were 3.3% and 2.9%, respectively, the sensitivity and specificity of prediction were the best.
Conclusions: Bilateral cataract surgery does not significantly change anisotropia. However, anisotropia in the bilateral cataract surgery population may serve as a predictor of the risk of developing binocular vision abnormalities after surgery.
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Details
- Title
- Aniseikonia Associated with Cataract Surgery and Its Impact on Post-Surgical Binocular Vision
- Creators
- Qingqing Tan - Affiliated Hospital of North Sichuan Medical CollegeXuan Liao - Affiliated Hospital of North Sichuan Medical CollegeChang-Jun Lan - Affiliated Hospital of North Sichuan Medical CollegeJames S. Lewis - Salus UniversityMitchell M Scheiman - Drexel University, Pennsylvania College of Optometry at Salus University (2008-2025)
- Publication Details
- Chinese Journal of Optometry and Visual Science [中华眼视光学与视觉科学杂志/#/中華眼視光學與視覺科學雜誌 Chung Hua Yen Shih Kuang Hsueh Yu Shih Chueh K'O Hsueh Tsa Chih]
- Resource Type
- Journal article
- Language
- Chinese; English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Scopus ID
- 2-s2.0-85201211716
- Other Identifier
- 991021901615304721