Visual acuity gain after cataract surgery improves the balance and gait parameters

1
Visual acuity gain after cataract surgery
improves the balance and gait parameters

• Sinan Emre1, Bekir Durmus2, Özlem Baysal2
• 1 Celal Bayar University, School of Medicine,
  Department of Ophthalmology, Manisa, Turkey
• 2 Inonu University, School of Medicine,
  Department of Physical Medicine Rehabilitation,
  Malatya, Turkey

Authors have no financial interest
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Introduction

• Postural disturbances in olders may lead falls,
  injuries, mortality
• 5 of falls fractures
• 10-15 of falls variety of injuries
• Cognitive impairment, muscle weakness, postural
  hypotension, visual impairment, balance and gait
  abnormalities, foot problems, and medications may
  lead postural instability

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Introduction

• Visual function is important for postural
  stability
• Vision timely information regarding the
  movements of body segments and position in
  relation to each other and the environment
• Integration of the somatosensory, vestibular and
  visual systems inputs play an important role in
  maintenance of the balance

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Purpose

• This study was to planned
  investigate the postural
  stability and mobility in
  cataract patients with
  various clinical tests
• To assess the potential improvement of postural
  stability and mobility scores after uncomplicated
  cataract surgery

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Patients and Method

• 17 patients, (12M/5F)
• Mean age 66.299.87 years (50-80)
• Uneventful Phaco for age-related cataract between
  May 2007-2008
• Patients were evaluated preoperatively and 1
  month after surgery at Departments of
  Ophthalmology and Physical Medicine Rehab
• Ophthalmic evaluation BCVA, Biomicroscopy, IOP,
  Ophthalmoscopy

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Patients and Method

• At Physical MedicineRehabilitation Dynamic
  postural stability assessed with BSS (Biodex) as
  antero-posterior stability index (APSI),
  medio-lateral stability index (MLSI) and overall
  stability index (OSI)
• Gait Analysis The gait velocity , step length,
  stride length, step width and cadence were
  evaluated
• Time Up and Go test (TUG) was measured

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Patients and Method

• Tinetti test gait and balance were evaluated
  using Tinetti balance and gait test which is a
  standardized evaluation of mobility stability
• Functional Reach test (FR) Subjects were asked
  to extend their arm to 90o and reach forward as
  far as possible without losing their balance or
  taking a step

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RESULTS
Preoperative (n17) Postoperative (n17) p
BCVA (LogMAR) 0.500.23 (0.20-1.00) 0.100.15 (0.00-0.50) lt 0.0001
OSI 4.520.99 (3.00-7.30) 3.410.78 (2.20-5.20) lt 0.0001
APSI 3.281.05 (1.40-5.70) 2.630.54 (1.80-3.80) 0.014
MLSI 3.250.90 (2.10-4.70) 2.270.74 (1.30-3.60) 0.002
Tinetti balance 14.761.30 (10.00-16.00) 15.700.77 (13.00-16.00) 0.006
Tinetti gait 11.350.93 (9.00-12.00) 11.820.39 (11.00-12.00) 0.033
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RESULTS
Preoperative (n17) Postoperative (n17) p
Gait velocity 122.6821.35 (99.70-170.65) 153.1423.16 (117.37-201.21) lt 0.0001
Cadence 1.850.44 (1.11-2.64) 2.160.46 (1.53-3.22) 0.002
TUG 11.502.69 (8.16-18.45) 8.741.62 (6.56-12.93) lt 0.0001
FR 28.414.50 (21.00-37.00) 32.294.96 (24.00-40.00) 0.001
No significant alteration for step length, stride
lenght walk base
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RESULTS Correlation Analysis
BCVA p
OSI 0.673 0.003
MLSI 0.506 0.038
Tinetti balance -0.551 0.022
Tinetti gait -0.689 0.002
Gait velocity -0.633 0.002
TUG -0.566 0.018
No significant correlation with APSI, step
length, stride length, cadence, walk base, FR
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CONCLUSION

• These results quantitatively documented that
  visual acuity gain after cataract surgery
  improves the gait and balance scores of patients
  with age-related cataract