The Influence of a Prolonged Interoperative Period on Binocular Vision after Bilateral Cataract Extractions

Abstract

Purpose

To evaluate the influence of the extent of the interoperative period on binocular vision function in patients after consecutive bilateral cataract extractions and intraocular lens implantation.

Methods

The study included patients operated due to bilateral cataract. Presence of asthenopic symptoms, distance and near squint angle, fusional amplitudes, stereopsis, and convergence were evaluated. Preoperative, interoperative, and postoperative differences in best-corrected visual acuity between eyes were also noted. Multivariate analysis was conducted in order to establish the relation between the interoperative period and binocular status.

Results

The study included 104 patients (74 female, 30 male, mean age 69.9 years, range 32-88). Mean interoperative period was 20.3 ± 12.9 months, range 1.5-47.7. Prolongation of the interoperative interval had a significant negative impact on stereopsis measured by TNO (R² = 0.215, p = 0.001) and Randot (R² = 0.179, p = 0.001) stereotests, as well as for near point of convergence (R² = 0.09, p = 0.002). It was also related, but not independently, to reduction in fusional amplitudes, mainly for distance (R² = 0.18, p = 0.001 for divergence and R² = 0.12, p = 0.001 for convergence). Asthenopic symptoms were reported by 17 (16.3%) patients. The incidence of exophoria was significantly (p = 0.002) higher in patients with an interoperative interval longer than 24 months.

Conclusions

The length of the interoperative period influences the status of binocular vision in patients after bilateral cataract extraction. It is also connected with an increased number of patients with asthenopic symptoms and exophoria.