Refractive changes in nuclear, cortical and posterior subcapsular cataracts. Effect of the type and grade

• Published in: Journal of optometry Vol. 8; no. 2; pp. 86 - 92
• Main Authors: Díez Ajenjo, M Amparo, García Domene, M Carmen, Peris Martínez, Cristina
• Format: Journal Article
• Language: English
• Published: Spain Elsevier Espana 01.04.2015; Elsevier
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Astigmatism - etiology; Cataract; Cataract - complications; Cataract - pathology; Cataract - physiopathology; Catarata; Compensación óptica; Contrast Sensitivity; Cortical; Female; Humans; Lens Cortex, Crystalline - pathology; Lens Nucleus, Crystalline - pathology; Lens, Crystalline - pathology; Male; Middle Aged; Myopia - etiology; Nuclear; Ophthalmology; Optical compensation; Original; Posterior subcapsular; Refractive Errors - etiology; Subcapsular posterior; Visual Acuity; Cataract; Optical compensation; Nuclear; Compensación óptica; Subcapsular posterior; Cortical; Catarata; Posterior subcapsular
• ISSN: 1888-4296; 1989-1342
• DOI: 10.1016/j.optom.2014.07.006

Abstract Purpose To determine the effect of main morphological types and grades of age-related cataracts on refractive error. Methods We measured 276 subjects with optical compensation prior to the development of cataract. We evaluated 224 eyes with nuclear cataract, 125 with cortical cataract, and 103 with posterior subcapsular (PSC) cataract classified with LOCSIII. We measured visual acuity (VA) with their spectacles and best-corrected visual acuity (BCVA) with chart in decimal scale to obtain the optimal compensation with cataract. We evaluated the differences between compensations. Results A significant myopic shift was observed in nuclear cataract from low to mild grade ( p = 0.031), the same as for PSC cataract from mild to advanced grade ( p = 0.025). No significant changes were found for cortical cataract ( p = 0.462). Regarding astigmatism, we observed power changes in cortical cataract from low to mild grade ( p = 0.03) and axis changes in PSC from low to mild grade ( p = 0.02) and in nuclear cataract from mild to advanced grade ( p = 0.02). Conclusions Cataract produces changes in patient's compensation which depend on severity and type of cataract. For nuclear and PSC cataract, we observed that the higher the grade of severity, the greater the myopic shift. Power astigmatic changes were found in cortical cataract and axis changes in PSC and nuclear cataract.