The Characteristics Of Relative Afferent Pupillary Defect In Patients With Asymmetric Cataracts

Objective: To prospectively investigate the incidence,associated factors,and prognostic significance of relative afferent pupillary defects(RAPD)in eyes with less severe cataract than that in contralateral eyes.Methods: Pupillary light reflex was performed in eighty patients with asymmetric cataract using a swinging flashlight test and computerized portable pupillometer before and after cataract surgery.Results: Forty-eight out of 80 patients(60%)had an RAPD in the eye with less severe cataract.The RAPD was resolved or switched to the contralateral eye after cataract extraction.There is no difference for visual acuity in the eyes of patients between RAPD group and those without RAPD(NRAPD group).There was no correlation between the presence of RAPD and postoperative visual acuity.Conclusion: There is high sensitivity and specificity in patients diagnosed with RAPD by using computerized portable pupilometer.The high sensitivity and specificity was achieved on both contraction amplitude and contraction velocity comparing to contraction latency.More than half patients with asymmetric cataract had an RAPD that was resolved after cataract emulsification and intraocular lens implantation.There is no correlation between the preoperative RAPD and postoperative visual acuity.