Garobbio Simona, Zuche Hanna, Hall Ursula, Giudici Nina L, Gabrani Chrysoula, Scholl Hendrik P N, Herzog Michael H
Laboratory of Psychophysics, Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
Department of Ophthalmology, University Hospital Basel, Basel, Switzerland.
J Vis. 2025 Aug 1;25(10):13. doi: 10.1167/jov.25.10.13.
Cataract surgery is the most commonly performed surgical procedure worldwide and is typically associated with an improvement in visual acuity (VA). This study aimed to examine how various visual functions, beyond VA and contrast sensitivity, are affected by cataracts and how they change after cataract surgery. We assessed 28 adults (aged 55-85 years) with vision-impairing cataracts using a comprehensive battery of visual tests at four visits: before surgery, 1 week after surgery of the first eye, 1 week after surgery of the second eye, and 1 month after the second surgery. Tests included VA, contrast sensitivity, coherent motion (CMot), orientation discrimination, visual search, and reaction time, assessed monocularly and binocularly. Both a cognitive and a self-assessment questionnaire were administered at the first and last visits. Results indicated that cataracts impaired all visual functions except CMot. Postoperatively, VA, contrast sensitivity, and CMot improved significantly, with marginal gains in orientation discrimination and no change in visual search or reaction times. Improvements were greater after the first surgery. Also, stronger correlations between low-level visual functions, cataract severity, and self-assessment scores were observed for the first operated eye. Cognitive scores correlated significantly with performances in CMot, orientation discrimination, and visual search. These findings suggest that cataracts strongly affect low-level visual processing, whereas higher-level tasks may be maintained through cognitive compensation. Cataract surgery recovers performance in most but not all visual tests, highlighting the importance of considering visual function beyond VA, as well as cognitive functioning, in ophthalmic clinical care.
白内障手术是全球最常开展的外科手术，通常与视力（VA）改善相关。本研究旨在探讨除视力和对比敏感度之外的各种视觉功能如何受到白内障影响，以及白内障手术后这些功能如何变化。我们对28名患有视力受损白内障的成年人（年龄55 - 85岁）进行了评估，在四次就诊时使用了一系列全面的视觉测试：手术前、第一眼手术后1周、第二眼手术后1周以及第二次手术后1个月。测试包括单眼和双眼评估的视力、对比敏感度、连贯运动（CMot）、方向辨别、视觉搜索和反应时间。在首次和末次就诊时发放了认知和自我评估问卷。结果表明，白内障损害了除CMot之外的所有视觉功能。术后，视力、对比敏感度和CMot显著改善，方向辨别略有提高，视觉搜索或反应时间无变化。第一次手术后改善更大。此外，对于第一只手术眼，在低水平视觉功能、白内障严重程度和自我评估分数之间观察到更强的相关性。认知分数与CMot、方向辨别和视觉搜索的表现显著相关。这些发现表明，白内障强烈影响低水平视觉处理，而高级任务可能通过认知补偿得以维持。白内障手术可恢复大多数但并非所有视觉测试的表现，突出了在眼科临床护理中考虑除视力之外的视觉功能以及认知功能的重要性。
