Illuminated near card assessment of potential visual acuity

Purpose: To determine the accuracy of predicting potential visual acuity in patients having neodymium:YAG (Nd:YAG) laser capsulotomy using a new device, the illuminated near card (INC). Setting: Private practice, New York, New York. Methods: Thirty-eight consecutive patients having Nd:YAG laser capsulotomy were studied prospectively by comparing the postoperative distance Snellen acuity to the visual acuity obtained preoperatively using (1) a near vision reading card, (2) the INC, and (3) the INC viewed through a pinhole. Results: Patients reported that the INC was easy to use; none with a visual acuity better than 20/200 had difficulty finding the illuminated letters through the pinhole. In eyes with a precapsulotomy distance acuity of better than 20/200, the correlation between precapsulotomy and postcapsulotomy acuities was statistically significant (P < .001) for the INC viewed through the pinhole. A significant correlation between precapsulotomy and postoperative acuities was not found for the INC viewed alone or for the near card (P > .05). In patients with a precapsulotomy distance acuity of 20/200 or worse, the INC with pinhole, the INC, or the near card did not predict postoperative acuity (P > .05). Conclusion: In eyes with a precapsulotomy distance acuity better than 20/200, the INC with pinhole predicted postoperative distance acuity within one Snellen line in 97% of eyes (29/30), which is comparable to reports using other potential acuity testers. The INC viewed through a pinhole improves image resolution by the stenopaic hole without the low light intensity of the reduced aperture.