Correlation between Cataract Morphology and Postoperative Visual Acuity in Patients Undergoing Phacoemulsification

Abstract

Introduction: For cataracts, the leading cause of reversible blindness worldwide, phacoemulsification is the preferred surgical technique. Visual results may vary based on cataract morphology, despite the lack of local evidence relating specific cataract forms to postoperative recovery.

Objective: to assess the relationship between postoperative visual acuity and cataract morphology in phacoemulsification patients.

Methodology: From January to December 2024, the Department of Ophthalmology at DHQ Hospital Kotli carried out this prospective observational study. 250 patients who were at least 40 years old and undergoing simple posterior chamber phacoemulsification Included was the implantation of intraocular lenses. Best corrected visual acuity (BCVA) and cataract grading using the Lens Opacities Classification System III (LOCS III) comprised the preoperative evaluation. At six weeks, postoperative BCVA was measured. Surgical parameters were recorded, such as phaco energy and effective phacoemulsification time (EPT). ANOVA and Pearson correlation were used to analyze the data using SPSS 26; p<0.05 was deemed significant.

Results: Mean age was 63.4 ± 9.2 years; 138 patients (55.2%) were male. Cataract types were nuclear (40.8%), cortical (27.2%), posterior subcapsular (PSC, 22.4%), and mixed (9.6%). Postoperative BCVA improved from 0.78 ± 0.25 to 0.12 ± 0.09 logMAR (p<0.001). PSC cataracts showed the greatest visual gain (0.83 ± 0.21 logMAR), while nuclear cataracts required the highest EPT and phaco energy. Overall, 87.2% achieved BCVA ≥6/12. Cataract morphology strongly correlated with visual improvement (r=-0.63, p<0.001). Complications were minimal.

Conclusion: Excellent visual recovery is possible with phacoemulsification, and cataract morphology has a major impact on the results. Surgical planning and patient counseling depend on the preoperative evaluation of cataract type.