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Visual Prognosis and Satisfaction of Advanced Cataract Patients Unable to be Evaluated by Fundus Imaging
안저검사상 망막이 관찰되지 않는 진행 백내장의 시력예후와 술 후 만족도
JKOS 2020 Mar;61(3):235-42
Published online March 15, 2020;  https://doi.org/10.3341/jkos.2020.61.3.235
Copyright © 2020 The Korean Ophthalmological Society.
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Jong In You, MD, Seul Ki Bang, MD, Min Seok Kang, MD, Kyung Hyun Jin, MD, PhD
유종인⋅방슬기⋅강민석⋅진경현

Department of Ophthalmology, KyungHee University Medical Center, KyungHee University School of Medicine, Seoul, Korea
경희대학교 의학전문대학원 경희대학교병원 안과학교실
Received May 2, 2019; Revised May 24, 2019; Accepted February 21, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: We evaluated the surgical prognoses of patients with advanced cataract who were unable to be evaluated by fundus imaging and their satisfaction with daily life.
Methods: We retrospectively reviewed 748 eyes of 480 patients who underwent cataract surgery from January 2015 to December 2017. Preoperative factors, surgical technique, degree of cataract, and the best-corrected visual acuity for 1 and 6 months after surgery were analyzed. Among 91 eyes of 78 patients with advanced cataract who were unable to be evaluated by fundus imaging, the degree of discomfort before surgery and postoperative satisfaction were evaluated.
Results: Hypertension was positively correlated with visual acuity after cataract surgery (p = 0.004). Low corneal endothelial cell count, primary open-angle glaucoma, a history of trabeculectomy due to glaucoma, corneal dystrophy or corneal opacity, advanced cataract unable to be evaluated by fundus imaging, hypermature cataract, extracapsular cataract extraction, and intracapsular cataract extraction and visual acuity <0.5 after 1 month showed negative correlations with the visual outcomes after 6 months (p = 0.019, p = 0.002, p = 0.037, p = 0.001, p = 0.004, p = 0.012, p = 0.00, and p = 0.00, respectively). The risk of a final visual acuity <0.5 after cataract surgery was 3.18-fold higher in cases of advanced cataract, unable to be evaluated by fundus imaging (p = 0.003). Ten patients with 10 eyes postponed surgery due to poor prognoses, which was expected, and six patients (60%) had a best-corrected visual acuity <0.5 after 6 months. Six patients (60%), expected to have a poor prognosis were satisfied after surgery and the postoperative satisfaction was high when compared with a poor visual outcome.
Conclusions: Poor surgical prognoses were expected in advanced cataract patients unable to be evaluated by fundus imaging. However, advanced cataract patients, who postponed surgery due to an unfavorable visual prognosis, showed a higher subjective satisfaction when compared with the postoperative visual acuity.
Keywords : Advanced cataract, Hypermature cataract, Mature cataract, Surgical outcome of cataract

 

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