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Abraham CH, Sakyi-Badu G, Boadi-Kusi SB, Morny E, Darko-Takyi C, Ocansey S, Hope PKF, Dadzie AK, Aboagye MacCarthy A, Osei-Frimpong K, Nyarkoa Opoku E, Kwasi Abu E. Simulation of visual impairment in persons with normal vision for scientific research. Ophthalmic Physiol Opt 2024; 44:442-456. [PMID: 38223917 DOI: 10.1111/opo.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/16/2024]
Abstract
Simulation of visual impairment in healthy eyes has multiple applications in students' training, research and product development. However, due to the absence of an existing standard protocol, the method of simulation was left to the discretion of the researcher. This review aimed to outline the various methods of simulating visual impairment and categorising them. A scoping review of the relevant publications was conducted. Of the 1593 articles originally retrieved from the databases, 103 were included in the review. The characteristics of the participants, the method for simulation of the visual impairment in persons with normal vision and the level or type of visual impairment that was simulated were extracted from the papers. None of the methods of simulation can be judged as being superior to the others. However, electronic displays produced the most consistent form of visual impairment simulation.
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Affiliation(s)
- Carl Halladay Abraham
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Godfred Sakyi-Badu
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | | | - Enyam Morny
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Charles Darko-Takyi
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | - Stephen Ocansey
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | | | - Albert Kofi Dadzie
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
| | | | | | | | - Emmanuel Kwasi Abu
- Department of Optometry and Vision Science, University of Cape Coast, Cape Coast, Ghana
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Ao M, Shi H, Li X, Huang H, Ao Y, Wang W. Effects of visual restoration on gait performance and kinematics of lower extremities in patients with age-related cataract. Chin Med J (Engl) 2023; 136:596-603. [PMID: 36877988 PMCID: PMC10106207 DOI: 10.1097/cm9.0000000000002509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly; however, the mechanism needs to be explored intensively. The present study assessed the gait pattern after cataract surgery to investigate the effects of visual restoration on locomotion. METHODS The prospective study recruited 32 patients (70.1 ± 5.2 years) with bilateral age-related cataracts in the Department of Ophthalmology at Peking University Third Hospital from October 2016 to December 2019. The temporal-spatial gait parameters and kinematic parameters were measured by the Footscan system and inertial measurement units. Paired t -test was employed to compare data normally distributed and Wilcoxon rank-sum test for non-normally distributed. RESULTS After visual restoration, the walking speed increased by 9.3% (1.19 ± 0.40 m/s vs. 1.09 ± 0.34 m/s, P =0.008) and exhibited an efficient gait pattern with significant decrease in gait cycle (1.02 ± 0.08 s vs. 1.04 ± 0.07 s, P =0.012), stance time (0.66 ± 0.06 s vs. 0.68 ± 0.06 s, P =0.045), and single support time (0.36 ± 0.03 s vs. 0.37 ± 0.02 s, P =0.011). High amplitude of joint motion was detected in the sagittal plane in the left hip (37.6° ± 5.3° vs. 35.5° ± 6.2°, P =0.014), left thigh (38.0° ± 5.2° vs. 36.4° ± 5.8°, P =0.026), left shank (71.9° ± 5.7° vs. 70.1° ± 5.6°, P =0.031), and right knee (59.1° ± 4.8° vs. 56.4° ± 4.8°, P =0.001). The motor symmetry of thigh improved from 8.35 ± 5.30% to 6.30 ± 4.73% ( P =0.042). CONCLUSIONS The accelerated gait in response to visual restoration is characterized by decreased stance time and increased range of joint motion. Training programs for improving muscle strength of lower extremities might be helpful to facilitate the adaptation to these changes in gait.
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Affiliation(s)
- Mingxin Ao
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Huijuan Shi
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing 100191, China
| | - Xuemin Li
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Hongshi Huang
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing 100191, China
| | - Yingfang Ao
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing 100191, China
| | - Wei Wang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
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Ao M, Ren S, Yu Y, Huang H, Miao X, Ao Y, Wang W. The effects of blurred visual inputs with different levels on the cerebral activity during free level walking. Front Neurosci 2023; 17:1151799. [PMID: 37139527 PMCID: PMC10149992 DOI: 10.3389/fnins.2023.1151799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Objective The aim of this study was to evaluate the effects of blurred vision on electrocortical activities at different levels during walking. Materials and methods A total of 22 healthy volunteers (all men; mean age: 24.4 ± 3.9 years) underwent an electroencephalography (EEG) test synchronous with free level walking. Visual status was simulated by goggles covered by the occlusion foil targeted at a Snellen visual acuity of 20/60 (V0.3), 20/200 (V0.1), and light perception (V0). At each of these conditions, the participants completed barefoot walking for five blocks of 10 m. The EEG signals were recorded by a wireless EEG system with electrodes of interest, namely, Cz, Pz, Oz, O1, and O2. The gait performances were assessed by the Vicon system. Results During walking with normal vision (V1.0), there were cerebral activities related to visual processing, characterized as higher spectral power of delta (Oz and O2 vs. Cz, Pz, and O1, p ≤ 0.033) and theta (Oz vs. Cz and O1, p = 0.044) bands in occipital regions. Moderately blurred vision (V0.3) would attenuate the predominance of delta- and theta-band activities at Oz and O2, respectively. At the statuses of V0.1 and V0, the higher power of delta (at V0.1 and V0, Oz, and O2 vs. Cz, Pz, and O1, p ≤ 0.047) and theta bands (at V0.1, Oz vs. Cz, p = 0.010; at V0, Oz vs. Cz, Pz, and O1, p ≤ 0.016) emerged again. The cautious gait pattern, characterized by a decrease in gait speed (p < 0.001), a greater amplitude of deviation from the right ahead (p < 0.001), a prolonged stance time (p = 0.001), a restricted range of motion in the hip on the right side (p ≤ 0.010), and an increased knee flexion during stance on the left side (p = 0.014), was only detected at the status of V0. The power of the alpha band at the status of V0 was higher than that at V1.0, V0.3, and V0.1 (p ≤ 0.011). Conclusion Mildly blurred visual inputs would elicit generalization of low-frequency band activity during walking. In circumstance to no effective visual input, locomotor navigation would rely on cerebral activity related to visual working memory. The threshold to trigger the shift might be the visual status that is as blurred as the level of Snellen visual acuity of 20/200.
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Affiliation(s)
- Mingxin Ao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Shuang Ren
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yuanyuan Yu
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Hongshi Huang
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Xin Miao
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
| | - Yingfang Ao
- Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, China
- *Correspondence: Yingfang Ao
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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敖 明, 李 学, 于 媛, 时 会, 黄 红, 敖 英, 王 薇. [Effects of visual restoration on dynamic plantar pressure features in elder individuals]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:907-914. [PMID: 34650293 PMCID: PMC8517682 DOI: 10.19723/j.issn.1671-167x.2021.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To analyze the effects of visual restoration after cataract surgery on plantar pressure and biomechanics of foot in elder individuals. METHODS Thirty-two patients [male/female 5/27, (70.1±5.2) years old] with age-related cataract were recruited between October 2016 and December 2019. The footscan system was employed to record the data of plantar pressure during level walking before and 1-month after the cataract surgery. Parameters of peak pressure (PP), impulse (I), pressure-time integral (PTI) and time to peak pressure (TPP) from the regions of the 1st toe (T1), 2nd to 5th toes (T2-5), 1st to 5th metatarsal heads (M1-M5), midfoot (MF), medial hindfoot (HM) and lateral hindfoot (HL) were analyzed respectively. RESULTS Post-operatively, the visual function was effectively reconstructed with improved visual acuity in both eyes (Z=-4.878, -4.801; P < 0.001). The PP (t=2.266, P=0.031) and I (t=2.152, P=0.039) values in M2 region on the dominant side (right foot) increased statistically at post-operative phase, while the changes of pressure and temporal para-meters in other regions remained stable. There was laterality in plantar pressure at pre-operative phase, manifested as greater PP values in M1, M2, MF, and HM regions on the dominant sides (t=-2.414, -2.478, -2.144, -5.269; P < 0.05), greater PP values in T1, M3, M5 and HL regions on the non-dominant sides (t=4.830, 3.155, 2.686, 3.683; P < 0.05), greater I values in M1, MF, and HM regions on the dominant sides (t=-2.380, -2.185, -5.320; P < 0.05) and greater I values in T1, M3, M5 and HL regions on the non-dominant sides (t=4.489, 2.247, 2.838, 3.992; P < 0.05). post-operatively, the pressure tended to be compatible between the two sides in regions of M3 and MF, while the magnitude of laterality in regions of M1 (ZPP△= -2.721, P=0.007; ZI△=-2.581, P=0.010), M2 (ZPP△=-2.674, P=0.007; ZI△=-2.375, P=0.018) and M5 (ZPP△=1.991, P=0.046; ZI△=2.150, P=0.032) was further increased. CONCLUSION Changes in plantar pressure after cataract surgery were characterized as increased pressure in the 2nd metatarsal head area on the dominant side. Visual restoration might intensify the laterality in the medial of forefoot on the dominant side and the lateral of forefoot on the non-dominant side.
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Affiliation(s)
- 明昕 敖
- 北京大学第三医院眼科, 眼部神经损伤的重建保护与康复北京市重点实验室Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - 学民 李
- 北京大学第三医院眼科, 眼部神经损伤的重建保护与康复北京市重点实验室Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - 媛媛 于
- 北京大学第三医院运动医学科, 北京大学运动医学研究所, 北京市运动医学关节伤病重点实验室, 北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 会娟 时
- 北京大学第三医院运动医学科, 北京大学运动医学研究所, 北京市运动医学关节伤病重点实验室, 北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 红拾 黄
- 北京大学第三医院运动医学科, 北京大学运动医学研究所, 北京市运动医学关节伤病重点实验室, 北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 英芳 敖
- 北京大学第三医院运动医学科, 北京大学运动医学研究所, 北京市运动医学关节伤病重点实验室, 北京 100191Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
| | - 薇 王
- 北京大学第三医院眼科, 眼部神经损伤的重建保护与康复北京市重点实验室Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
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Hall CD, Barnes CS, Gutherie AH, Lynch MG. Visual function and mobility after multifocal versus monofocal intraocular lens implantation. Clin Exp Optom 2021; 105:70-76. [PMID: 33730524 DOI: 10.1080/08164622.2021.1896337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Clinical relevance: Mobility and fall risk may be important considerations in choosing between intraocular lenses.Background: Fall risk in older adults increases when wearing multifocal spectacles, but little is known about mobility among individuals with different types of intraocular lenses. This study compared visual function, fall risk and balance control following bilateral implantation of monofocal or multifocal intraocular lenses.Methods: This was a non-randomised, cross-sectional study involving adults with bilateral intraocular lenses. Participants completed questionnaires concerning physical functioning, fall history and balance-related confidence. Binocular visual acuity, contrast sensitivity (Pelli-Robson chart and computerized testing), depth perception and glare sensitivity were assessed. Physical performance measures included the Sensory Organization Test, preferred gait speed, Dynamic Gait Index and wayfinding in a virtual environment.Results: Fifteen participants (mean ± standard deviation, 67.1 ± 6.8 years) had monofocal intraocular lenses and 14 participants (68.1 ± 6.1 years) had multifocal intraocular lenses. Contrast sensitivity in the monofocal group was significantly better than that in the multifocal group (p = 0.02) at intermediate and high spatial frequencies. Contrast sensitivity of the monofocal group also was less affected by glare than the contrast sensitivity of the multifocal group, at an intermediate spatial frequency (p = 0.02). However, the multifocal group had significantly better Dynamic Gait Index scores (p = 0.04), even after controlling for perceived physical function.Conclusions: The participants with monofocal intraocular lenses generally had better contrast sensitivity than did those with multifocal intraocular lenses. However, the scores on a mobility test that is associated with fall risk were worse for those with monofocal lenses.
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Affiliation(s)
- Courtney D Hall
- Hearing and Balance Research Program, James H. Quillen VA Medical Center, Mountain Home, TN, USA.,Physical Therapy Program, College of Clinical and Rehabilitative Health Sciences, East Tennessee State University, Johnson City, TN, USA
| | | | - Audrey H Gutherie
- Rehabilitation Research & Development Center, Atlanta VA Medical Center, Decatur, GA, USA
| | - Mary G Lynch
- The Eye Clinic, Atlanta VA Medical Center, Decatur, GA, USA
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Bicket AK, Mihailovic A, E JY, Nguyen A, Mukherjee MR, Friedman DS, Ramulu PY. Gait in Elderly Glaucoma: Impact of Lighting Conditions, Changes in Lighting, and Fear of Falling. Transl Vis Sci Technol 2020; 9:23. [PMID: 33364078 PMCID: PMC7745602 DOI: 10.1167/tvst.9.13.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/29/2020] [Indexed: 12/23/2022] Open
Abstract
Purpose The purpose of this study was to characterize the impact of lighting changes on gait in elderly patients with glaucoma and evaluate whether associations are mediated by fear of falling (FOF). Methods Gait initiation and parameters measured with the GAITRite Electronic Walkway were captured in normal indoor light, then in dim light, and again in normal light (normal post dim [NPD]). Participants’ right and left eye visual fields (VFs) were merged into integrated VF (IVF) sensitivities. FOF was evaluated using a Rasch-analyzed questionnaire. Multivariable regression models evaluated whether IVF sensitivity was associated with lighting-dependent gait changes and if this relationship was mediated by FOF. Results In 213 participants (mean age = 71.4 years), gait initiation in dim light took longer with more VF damage (P = 0.02). Greater VF damage was associated with slower gait in dim (P < 0.001) and NPD (P = 0.003) lighting, as well as shorter strides (P = 0.02), broader stance (P = 0.003), and more variable stride velocity and length in all lighting (all P < 0.03). When moving from normal to dim lighting, those with more VF damage slowed gait and cadence, shortened stride length, and lengthened double support time (all P < 0.001). Velocity, cadence, and double support time did not return to baseline in NPD lighting (all P < 0.05). Fear of falling did not appear to mediate the relationship between IVF sensitivity and lighting-dependent gait changes. Conclusions Patients with more VF damage demonstrate gait degradation in extreme or changing lighting, which is not mediated by FOF. Translational Relevance Quantitative spatiotemporal gait evaluation reveals lighting-associated impairment, supporting patient-reported difficulty with nonideal lighting and equipping providers to advise patients about limitations.
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Affiliation(s)
- Amanda K Bicket
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jian-Yu E
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Angeline Nguyen
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - David S Friedman
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Subjective Happiness and Satisfaction in Postoperative Anisometropic Patients after Refractive Surgery for Myopia. J Clin Med 2020; 9:jcm9113473. [PMID: 33126654 PMCID: PMC7693991 DOI: 10.3390/jcm9113473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 01/01/2023] Open
Abstract
Laser-assisted in situ keratomileusis (LASIK) contributes to increased patient happiness one month after surgery; however, longer term effects are unknown. We performed a retrospective cross-sectional study on 472 patients who underwent bilateral LASIK surgery to measure happiness and satisfaction with LASIK, and to identify affecting factors. Patients completed questionnaires on satisfaction with the surgery and the subjective happiness scale (SHS) before, and 1, 3, 6, and 12 months after surgery. Multiple regression analyses were performed to determine independent predictors of SHS and satisfaction scores. Mean SHS increased at one month but was similar to baseline levels by six months. The SHS of older patients was greater than younger ones at baseline and at one and three months, while satisfaction among the older group was poorer at one and three months. Multiple regression analyses revealed that the decrease in SHS score from one month to three months correlated with baseline SHS, SHS at one month, uncorrected distance visual acuity (UDVA), and age. Regression analysis revealed SHS at six months correlated with preoperative SHS, SHS at one month, and satisfaction at six months. Satisfaction at final visit correlated with age, UDVA, anisometropia, and with SHS at each visit. We conclude that happiness and satisfaction were age- and UDVA-dependent, and anisometropic patients report poorer satisfaction scores.
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Kokune-Takahashi A, Ayaki M, Tsubota K, Negishi K. Effects of Cataract Opacity and Surgery on Sleep Quality. Rejuvenation Res 2017; 21:53-60. [PMID: 28728538 DOI: 10.1089/rej.2016.1907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This study aimed to identify the type of cataract opacity associated with subjective sleep quality for cataract patients. A total of 180 consecutive patients (average age 74.2 years) underwent cataract surgery with implantation of an ultraviolet-blocking or blue light-blocking intraocular lens. The participants' subjective sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI) before and at 2 months after surgery. Patients were divided into two groups for analysis: normal sleepers (preoperative PSQI ≤5) and poor sleepers (preoperative PSQI ≥6). The preoperative and postoperative PSQI scores were 2.8 ± 1.5 and 3.2 ± 2.0, respectively, for normal sleepers (n = 99), and 8.5 ± 2.9 and 7.4 ± 3.3, respectively, for poor sleepers (n = 81). The improvement in PSQI was significant in poor sleepers (p < 0.0001, Wilcoxon's test) with measured values of 0.22 ± 0.96 hours extension in sleep duration and 0.16 ± 0.62 hours shortening in sleep latency. Patients with posterior subcapsular cataract (PSC) and nuclear opacity showed the greatest improvement in PSQI score, with regression analysis identifying PSC as having a significant effect on improvement in PSQI. Significant correlations were found between the subjective sleep and cataract opacity in cataract patients. Ophthalmic personnel should therefore be aware that cataract patients with PSC have a greater potential for disability and predictable benefits from surgery in vision and subjective sleep.
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Affiliation(s)
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine , Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine , Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine , Tokyo, Japan
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