Muhtaseb et al developed a score which can help to identify a patient who may have problems during cataract surgery. The authors are from Moorfields Eye Hospital at St. George's Hospital in London.
Parameters:
(1) dense, total, white, brunescent cataract
(2) pseudoexfoliation
(3) phacodonesis (weak zonules)
(4) previous vitrectomy
(5) corneal scarring or cloudiness
(6) pupil size
(7) anterior chamber depth
(8) age of the patient
(9) ametropia
(10) posterior capsule plaque
(11) posterior polar cataract
(12) miscellaneous risk factors
|
Parameter |
Finding |
Points |
|---|---|---|
|
dense, total, white, brunescent cataract |
no |
0 |
|
|
yes |
3 |
|
pseudoexfoliation |
absent |
0 |
|
|
present |
3 |
|
phacodonesis |
absent |
0 |
|
|
present |
3 |
|
previous vitrectomy |
no |
0 |
|
|
yes |
1 |
|
corneal scarring |
absent |
0 |
|
|
present |
1 |
|
pupil size |
not small (>= 3 mm) |
0 |
|
|
small (< 3 mm) |
1 |
|
anterior chamber depth |
not shallow (>= 2.5 mm) |
0 |
|
|
shallow (< 2.5 mm) |
1 |
|
age of the patient |
<= 88 years of age |
0 |
|
|
> 88 years of age |
1 |
|
ametropia |
not high |
0 |
|
|
high (> 6 D of myopia or hyperopia) |
1 |
|
posterior capsule plaque |
absent |
0 |
|
|
present |
1 |
|
posterior polar cataract |
absent |
0 |
|
|
present |
1 |
|
miscellaneous risk factors |
absent |
0 |
|
|
present |
1 |
where:
• A brunescent cataract is one with a brown or amber core.
total score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18 (or 17 if posterior polar cataract is not scored for a dense, total, white, brunescent cataract)
• The higher the score the greater the intraoperative risk for a complication.
|
Total Score |
Risk Group |
Overall Complications |
|
0 |
no added risk |
4.3% |
|
1 or 2 points |
low |
7.5% |
|
3 to 5 points |
moderate |
13.5% |
|
>= 6 points |
high |
32% |
Purpose: To evaluate a patient prior to cataract surgery using the score of Muhtaseb et al.
Specialty: Ophthalmology
Objective: risk factors, severity, prognosis, stage
ICD-10: H26.9,
