Perea-Milla et developed scores for evaluating a patient undergoing cataract surgery. One score predicts the change in the VF-14. The authors are from Investigacion en Resultados de Salud y Servicios Sanitarios (IRYSS) Cataract Group in Spain.
Patient selection: cataract surgery
Outcome: based on minimal clinically important difference (MCID) as "somewhat better" on postoperative testing. The MCID for the VF-14 was 15.6
Parameters:
(1) preoperative VF-14 (from 0 to 100)
(2) better-seeing eye
(3) surgical complexity (positive there are favorable factors, negative if unfavorable factors, or neutral if neither favorable nor unfavorable)
Positive factors for surgical complexity: white cataract
Negative factors for surgical complexity: (1) narrow anterior chamber, (2) deep-set eyes, (3) posterior synechiae, (4) poor pupil dilatation requiring mechanical dilatation, (5) vitrectomized eye, and (6) subluxation of the crystalline lens
Neutral factors for surgical complexity: (1) fibrosis of the anterior capsule of the crystalline lens, (2) brunescent cataract, (3) posterior polar cataract, (4) extreme myopia without retinal involvement, (5) poor pupil dilatation not requiring mechanical dilatation, (6) pseudo-exfoliation with midriasis > 3 mm and without subluxation of the crystalline eyes and (7) poor patient cooperation.
Parameter |
Finding |
Points |
preoperative VF-14 |
< 45 |
10 |
|
45 to 70 |
7 |
|
> 70 |
0 |
better-seeing eye |
operated eye |
1 |
|
contralateral eye |
0 |
|
both equal |
0 |
surgical complexity |
positive |
4 |
|
neutral |
2 |
|
negative |
0 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15 (The paper states 24 but the additional 9 points is not accounted for in Table 4)
• A score >= 6 was associated with improved VF-14 after surgery.
Performance:
• The area under the ROC curve was 0.80.
Specialty: Ophthalmology