Contrast Sensitivity Clinical Trial
Official title:
Contrast Sensitivity Assessment in Pediatric Cataract Surgery With IOL Implantation: A Comparison of Preoperative and Early Postoperative Outcomes
The study evaluates contrast sensitivity in older children following surgery for lamellar
and posterior subcapsular cataracts. Often, pediatric surgeons tend to delay surgery in
these children who present beyond the amblyogenic age group. These cataracts are often
compatible with reasonable visual acuity and therefore some surgeons prefer to wait for
surgery, whereas others tend to operate.
The study evaluates improvement in contrast sensitivity at different spatial frequencies
following cataract surgery for lamellar and posterior subcapsular cataracts in older
children.
All patients undergoes temporal clear corneal incision, manual anterior continuous
curvilinear capsulorhexis, bimanual irrigation/aspiration for lens removal and residual
cortex, posterior capsule management based on the age of the patient either manual posterior
capsulorhexis (PCCC) upto 6 years or leaving intact posterior capsule and implantation of
single-piece AcrySof SN60WF (Alcon Laboratories, Forth Worth, Texas) hydrophobic acrylic IOL
in-the-bag. Postoperatively, all the patients are examined first for high contrast
sensitivity and then for low contrast at 1 week, 1 and 3 months respectively.
The results are analyzed for corrected distance visual acuity (CDVA) which is recorded in
LogMAR units at preoperative and 1 and 3 months postoperatively. Monocular high-contrast
Snellen visual assessment for distance is done with the Early Treatment Diabetic Retinopathy
Study chart (Vector Vision acuity chart at 100% contrast) with Corrected distance visual
acuity CDVA at 4 m under photopic condition.
Similarly at preoperative and 1 and 3 months postoperatively contrast sensitivity testing is
also performed using the CSV 1000E sine wave grating test face (Vector Vision, USA) with the
patient seated at a distance of 2.5 m from the chart. The test is performed after the
patient is adapted to the room luminance for 5 minutes. The non viewing eye was occluded for
each measurement, and the best spectacle refractive correction is placed in front of the
viewing eye. Testing is being tested under two lighting conditions: photopic (85cd/m2) and
mesopic (2.7cd/m2). The contrast sensitivity values are documented in log units. Sensitivity
levels at each frequency range from 0.7 to 2.08 (3 cpd), 0.91 to 2.29 (6 cpd), 0.61 to 1.99
(12 cpd), and 0.17 to 1.55 (18 cpd) log units. This testing is performed with the patient
wearing their refractive correction in form of spectacles.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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