Contrast visual acuities in cataract patients

We compared pre- and postoperative visual acuities in 45 cataract patients without ocular pathology except lens opacity (group 1) and 20 patients with ocular pathologies and lens opacity (group 2) using Variable Contrast Visual Acuity Charts. Charts 1 and 4 have 90% contrast; chart 4 has white optotypes on a black background (reverse polarity), charts 2 and 3 have 15% and 2.5% contrast, respectively. The mean preoperative visual acuities of groups 1 and 2 measured with the high-contrast Landolt optotypes ranged from 0.02-0.80 and 0.22-0.40, respectively. Visual acuity improvements between the pre- and postoperative periods ranged from 1.37-1.61 and 0.52-1.24 octaves in groups 1 and 2, respectively, with the different charts. Visual acuity improvement was poorest with chart 3. The group 1 mean preoperative visual acuity measured with chart 2 was 1.11 octaves lower than with chart 1. In group 2, the visual acuity reduction was 1.81 octaves. The relation between the visual acuities measured with the high-contrast intermediate-contrast optotypes are important for predicting postoperative visual acuity improvement. An abnormal contrast acuity profile may indicate the presence of additional ocular pathologies.