Associations between Macular Sensitivity and Fixation in Pseudophakic Children after Congenital Cataract Surgery

ABSTRACT

Purpose: To investigate the associations between macular sensitivity (MS) and fixation in pseudophakic children after congenital cataract surgery.

Materials and Methods: In total 55 pseudophakic eyes and 28 healthy phakic eyes were included in this cross-sectional study. MS and fixation stability in term of 95% bivariate contour ellipse area (BCEA) were assessed with a Macular Integrity Assessment microperimeter. Central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) was measured with optical coherence tomography. MS inside and outside the 95% BCEA was compared. Influencing factors for the difference in MS between the two regions (ΔMS) were assessed.

Results: The overall MS was significantly lower in pseudophakic eyes than in the controls (P < .001). In the pseudophakic group, fixation stability was stable/relatively unstable/unstable in 69.1%/16.4%/14.5% of eyes, and their MS was 27.60 ± 2.56, 25.02 ± 3.82, and 20.50 ± 7.15 dB, respectively. The unstable subgroup had significantly worse MS than the stable subgroup (P < .001). Among pseudophakic eyes, the MS inside the 95% BCEA (fixation preferred region) was significantly greater than that outside this region (P = .048), and it was more correlated with BCVA than that of the entire macula. The ΔMS became greater in those pseudophakic eyes with worse fixation stability (P < .001) and longer axial length (P = .002). Backward stepwise multiple linear regression also revealed 95%BCEA and axial length had significant influences on ΔMS (R² = 0.289, P < .001).

Conclusion: MS was lower in pseudophakic eyes with poor fixation. Macular sensitivity inside and outside the fixation preferred region was different in pseudophakic children after congenital cataract surgery, and this difference increased with longer axial length and poorer fixation.

KEYWORDS:

• Macular sensitivity
• fixation stability
• congenital cataract
• pseudophakic
• axial length

Acknowledgments

The authors declare that there is no conflict of interest regarding the publication of this article.

Author contributions

Study design (X.J.Z.); study performance (W.W.H., Y.D., Y.L.Z.); data collection and management (Y.D., Y.J.F., Y.L.Z.); data analysis and interpretation (X.J.Z., W.W.H., Y.J.F.); writing and review of the manuscript (X.J.Z., Y.L.). All the authors have approved the manuscript.

Additional information

Funding

This work was supported by research grants from the National Natural Science Foundation of China (grant nos. 81870642, 81470613, 81670835, and 81270989), the Shanghai Pediatric Cataract Study, the Shanghai Talent Development Fund (grant no. 201604), the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission (grant no. 2017YQ011).