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Preoperative clinical scores may portend visual acuity, function after phaco
Ophthalmology. 2011;118(1):9-16.
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Clinical prediction scores based on preoperative data correlated with visual acuity and visual function scores after phacoemulsification, a study found.
"A clinical score could help improve patient selection, offer patients more comprehensive counseling, and reduce the discrepancy between expectations and actual outcomes of cataract surgery," the study authors said.
The prospective study included baseline examination data of 5,512 patients scheduled to undergo phacoemulsification at 17 centers in Spain. Patients were randomly assigned to two subgroups; a derivation group included 3,285 patients, and a validation group included 2,227 patients.
Multivariate logistic regression was used to determine parameters predictive of postoperative gains in visual acuity and visual function index 14 (VF-14) scores. Primary outcome measures were probability of postoperative improvement in visual acuity and VF-14 scores.
Predictive variables for improvement in visual acuity were baseline visual acuity, patient age, ocular comorbidity and complexity of the surgical technique. Predictive variables for improved visual function were preoperative VF-14 scores, eye with the better visual acuity and complexity of the surgical technique.
Final scores were ranked 0 (minimal level of function) to 100 (maximal function). Final visual acuity scores ranged from 0 to 44. Final VF-14 scores ranged from 0 to 24.
Study results showed that preoperative predictive scores had positive predictive values of 74% to 85%. Sensitivity for the VF-14 models ranged from 79% to 82%. Sensitivity for the visual acuity model ranged from 69% to 72%, the authors reported.