Scores of Perea-Milla et al for Visual Outcome After Cataract Surgery: Score for Change in Visual Acuity (VA)

 

Patient selection: cataract surgery

 

Outcome: based on minimal clinically important difference (MCID) as "somewhat better" on postoperative testing. The MCID for visual acuity was 0.41.

 

Parameters:

(1) preoperative visual acuity (Snellen optotypes, from 0 to 1)

(2) age in years

(3) ocular comorbidity (diabetic retinopathy, etc)

(4) 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 visual acuity	<= 0.1	18
	0.2 to 0.4	14
	>= 0.5	0
age in years	< 65 years	8
	65 to 69 years	6
	70 to 74 years	4
	75 to 79 years	0
	>= 80 years	0
ocular comorbidity	none (simple cataract)	6
	present	0
surgical complexity	positive	12
	neutral	8
	negative	0

 

where:

• The table has <= 65 and 65 to 69 as two separate categories.

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 44

• A score >= 26 is associated with improved visual acuity after surgery.

 

Performance:

• The area under the ROC curve was 0.64, which is low.