Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Curr Eye Res. 2023 May;48(5):512-517. doi: 10.1080/02713683.2023.2171438. Epub 2023 Jan 30.
Studies on age-related macular degeneration often use rod-mediated dark adaptation (RMDA) to evaluate macular functional health, studying eyes with cataract and pseudophakic eyes within the same sample. We examine a poorly understood issue-whether rod intercept time (RIT), a measure of RMDA, changes after cataract surgery and intraocular lens (IOL) insertion as compared to RIT before cataract surgery. Cataract may serve as a filter reducing photo-bleach magnitude prior to surgery, biasing RMDA interpretation.
A pre-/post-cataract surgery design was used. Persons with nuclear sclerotic and/or cortical cataract per the electronic health record were enrolled. Prior to cataract surgery, visual acuity, RMDA, and the LOCS III classification documenting cataract presence/severity were measured. Thirty days after surgery (mean), visual acuity and RMDA were repeated, followed by fundus photos to document macular health.
Twenty-four participants (mean age 72.7 years, standard deviation 5.6) enrolled. All eyes had nuclear sclerotic and nuclear color cataract; 68% had cortical cataract. All IOLs were monofocal with 21 having blue blocking characteristics and 3 had clear IOLs. Most eyes had higher RIT post-surgery (15.6 min, SD 6.7) as compared to pre-surgery (13.7 min, SD 6.4), = 0.0006, meaning that RMDA was slower post-surgery. Eyes with moderate cataract (<4 on any LOCS III grade) had RIT that increased on average by 0.7 min; those with more advanced cataract (≥4) had RIT that increased by 3.1 min ( = 0.0116). Results were unchanged when clear IOLs were removed from analysis.
RMDA was significantly slower (RIT was greater) following cataract surgery, with the greatest impact on RIT in older eyes after surgery for more advanced cataract. These findings suggest that persons with more advanced cataract may bias results when evaluating RMDA using RIT.
年龄相关性黄斑变性的研究常使用杆状细胞介导的暗适应（RMDA）来评估黄斑功能健康，在同一样本中研究白内障眼和人工晶状体（IOL）植入术后的眼。我们研究了一个尚未被充分了解的问题——白内障手术后，与术前相比，杆状细胞截获时间（RIT），即 RMDA 的一个衡量指标，是否会发生变化。白内障可能会作为一种过滤器，在手术前减少光漂白的幅度，从而影响 RMDA 的解读。
采用白内障术前/术后设计。根据电子病历，招募患有核性硬化性和/或皮质性白内障的患者。在白内障手术前，测量视力、RMDA 和记录白内障存在/严重程度的 LOCS III 分类。术后 30 天（平均）时，重复测量视力和 RMDA，然后拍摄眼底照片以记录黄斑健康。
24 名参与者（平均年龄 72.7 岁，标准差 5.6）入组。所有眼睛均有核性硬化性和核性彩色白内障；68%有皮质性白内障。所有 IOL 均为单焦点，其中 21 个具有蓝光阻断特性，3 个为透明 IOL。与术前相比，大多数术后眼睛的 RIT 更高（15.6 分钟，SD 6.7）， = 0.0006，这意味着 RMDA 在术后更慢。白内障程度较轻（任何 LOCS III 等级均<4）的眼睛的 RIT 平均增加 0.7 分钟；白内障程度较重（≥4）的眼睛的 RIT 增加 3.1 分钟（ = 0.0116）。当将透明 IOL 从分析中去除时，结果保持不变。
白内障手术后 RMDA 明显减慢（RIT 增加），在白内障手术后，年龄较大的眼睛中，白内障程度越严重，对 RIT 的影响越大。这些发现表明，在评估 RMDA 时，白内障程度较重的患者可能会对 RIT 产生偏倚。
