Illuminated near card assessment of potential acuity in eyes with cataract

Objective: This study aimed to determine the accuracy and potential role of the illuminated near card (INC) for predicting visual outcome after cataract surgery in eyes with and without comorbid disease. Study Design: A consecutive case series. Participants: A total of 101 preoperative patients with cataracts participated. Main Outcome Measures: Accuracy of predicted postoperative distance acuity was measured. Method: The preoperative acuity obtained with the INC was compared by linear regression to the postoperative INC acuity and the postoperative distance acuity for 100 consecutive eyes undergoing cataract surgery. Variables analyzed were preoperative distance acuity and the presence or absence of comorbid disease. Results: The preoperative INC acuity was significantly predictive of postoperative INC (P = 0.0005) and postoperative distance (P = 0.0007) acuities for the 100 eyes studied. For the subgroup of 15 eyes with 20/200 or worse, the preoperative INC acuity was not predictive of postoperative INC acuity (P = 0.8673) or postoperative distance acuity (P = 0.8789), For the 21 eyes with comorbid disease, the predictions were more accurate for postoperative INC acuity (P < 0.0001) and postoperative distance acuities (P < 0.0001) than for 64 eyes without comorbid disease: postoperative INC acuity (P = 0.0051), and postoperative distance acuity (P = 0.0046). The INC predicted postoperative distance acuity to within two lines in 98% of eyes when preoperative distance acuity was 20/100 or better, When the preoperative distance acuity was 20/200 or worse, the postoperative distance vision was predicted to within two lines in only 53% of the eyes. Conclusion: The INC can be a useful adjunct for predicting postoperative distance acuity in eyes with cataract that have preoperative distance acuity of 20/100 or better, particularly in eyes with comorbid disease, in which the clinical judgment of vision potential may be difficult.