Predicting Post-Cataract Surgery Visual Acuity in Vitrectomized Eyes: The Efficacy and Accuracy of "Lambda" Retinometry

Ophthalmic Surg Lasers Imaging Retina. 2021 Oct;52(10):535-542. doi: 10.3928/23258160-20210926-01. Epub 2021 Oct 1.

Abstract

Background and objective: Determine the ability of Lambda retinometry to predict post-cataract surgery visual acuity in vitrectomized eyes.

Patients and methods: Prospective study including 47 cataract surgery candidates with a history of pars plana vitrectomy (PPV). Lambda retinometry using a hand-held Lambda retinometer and best-corrected visual acuity (BCVA) were measured preoperatively, and BCVA was reassessed postoperatively.

Results: Lambda predictions strongly correlated with postoperative BCVA (logarithm of the minimum angle of resolution [logMAR]) (P < .001, r2 = 0.57), especially combined with preoperative BCVA (logMAR) (P < .001, r2 = 0.65). In 89% of cases, postoperative BCVA was equal to or higher than the prediction. Neither cataract grades nor indications for PPV were associated with the accuracy of Lambda predictions (P = .882 and P = .790, respectively). Underestimation of visual outcome was more common than overestimation. A Lambda prediction of ≥ 20/40 (Snellen) had a positive predictive value of 85.7% and a negative predictive value of 73.6% for the postoperative outcome.

Conclusions: Lambda retinometry can reliably predict the postoperative BCVA in cataract patients who previously underwent PPV, with a tendency towards underestimation. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:535-542.].

MeSH terms

  • Cataract Extraction*
  • Cataract* / complications
  • Cataract* / diagnosis
  • Humans
  • Prospective Studies
  • Visual Acuity
  • Vitrectomy