Visual acuity gain after cataract surgery improves the balance

and gait parametersSinan 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

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

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

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

Patients and Method• 17 patients, (12M/5F)• Mean age 66.29±9.87 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

Patients and Method• At Physical Medicine&Rehabilitation: 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

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

Preoperative (n=17) Postoperative (n=17) p=

BCVA

(LogMAR)0.50±0.23 (0.20-1.00) 0.10±0.15 (0.00-0.50) < 0.0001

OSI 4.52±0.99 (3.00-7.30) 3.41±0.78 (2.20-5.20) < 0.0001

APSI 3.28±1.05 (1.40-5.70) 2.63±0.54 (1.80-3.80) 0.014

MLSI 3.25±0.90 (2.10-4.70) 2.27±0.74 (1.30-3.60) 0.002

Tinetti

balance14.76±1.30 (10.00-16.00) 15.70±0.77 (13.00-16.00) 0.006

Tinetti

gait11.35±0.93 (9.00-12.00) 11.82±0.39 (11.00-12.00) 0.033

RESULTS

Preoperative (n=17) Postoperative (n=17) p=

Gait

velocity

122.68±21.35

(99.70-170.65)

153.14±23.16

(117.37-201.21)< 0.0001

Cadence1.85±0.44

(1.11-2.64)

2.16±0.46

(1.53-3.22)0.002

TUG11.50±2.69

(8.16-18.45)

8.74±1.62

(6.56-12.93)< 0.0001

FR28.41±4.50

(21.00-37.00)

32.29±4.96

(24.00-40.00)0.001

No significant alteration for step length, stride lenght & walk base

RESULTS

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

RESULTS: Correlation Analysis

CONCLUSION• These results quantitatively documented

that visual acuity gain after cataract surgery improves the gait and balance scores of patients with age-related cataract