Dr. Shobhana Phukan, Dr. Ratish Chandra Paul
Introduction:
Retinal acuity meter (RAM) is a device used to assess visual acuity of patients in presence of media opacities. How accurately RAM predicts potential acuity in presence of cataract is not very much clear. There are only few literatures regarding accuracy of RAM in cataract patients. Hence the present study is carried out to determine accuracy of RAM in predicting post operative BCVA in cataract patients.
Aims and Objectives:
To determine accuracy of retinal acuity meter (RAM) in predicting post operative BCVA in cataract patients.
Methods:
A prospective study taking a total no. of 100 patients with Cataract with unpredictable post operative visual outcome were considered. Pre operative potential acuity was measured with RAM in all patients. All patients underwent phacoemulsification followed by refraction for BCVA one week postoperatively. Pre operative potential acuity by RAM was compared with post operative BCVA .The study was conducted from April 2017 to March 2018 at a tertiary eye care centre.
Inclusion criteria:
Cataract patients with unpredictable post operative visual outcome-
- prediction not possible by refraction/ PH
- improper history
- Co-morbid disease eg. Glaucoma, retinal pathology
- visual loss disproportionate to cataract
- amblyopia
Exclusion criteria :
- RAM reading < 6/60
- Per operative complication
- Post operative complication eg. CME
- Un co-operative patients
Results:
Out of 100 patients, most of the patients were in the age group of 50-60 years. Most of them were male with male female ratio of 3:2.
Table 1.Involved eye
| Right | Left | Total |
| 45 | 55 | 100 |
Table 2.Comparison between potential acuity by RAM and post-op BCVA
| Total No. of eyes | Potential acuityby RAM matched with post-op BCVA | Potential acuity by RAM Not matched with post-op BCVA | ||
| 100 | Number | Percentage | Number | Percentage |
| 67 | 67% | 33 | 33% | |
Discussion:
RAM is found to be easy, economical and quick test (Approximately one min). In the present study, in 67 eyes (67%), potential visual acuity by RAM has matched with post op BCVA, which suggests good predictability. In another study, by SuzzanaAiriani et al, on RAM vs PAM found that RAM is a useful device to help predict BCVA after phacoemulsification. RAM was more likely to give exact prediction of postoperative BCVA as compared to PAM.(1)Maria Milia et all in a study on predictability of postoperative visual acuity in patients with dry ARMD using RAM found that, post operative BCVA predictability was more valuable in cases of nuclear and cortical cataracts, and was not affected by factors such as stage of AMD, age and sex.(2)
Conclusion:
RAM is very helpful in assessing post operative visual acuity.It is inexpensive, quick, easy for both patients and technician.
References:
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Toric IOLs: correcting astigmatism while controlling axis shift. J Cataract
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- Grabow HB. Toric IOL report. Ann Ophthalmol 1997, 29:161–163
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A comparison of keratometric variation in manual and
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- Ferreira TB, Berendschot TT, Ribeiro FJ.
Clinical outcomes after cataract surgery with a new transitional
toric intraocular lens. J Refract Surg. 2016;32:452–9.
- Vale C, Menezes C, Firmino-Machado J, Rodrigues P, Lume M, Tenedório
P, et al.
Astigmatism management in cataract surgery with precision (®) toric
intraocular lens: A prospective study. Clin Ophthalmol. 2016;10:151–9.
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