1. Visual acuity gain after cataract surgery improves the balance and gait parameters Sinan Emre 1, Bekir Durmus 2, Özlem Baysal 2 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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 90 o and reach forward as far as possible without losing their balance or taking a step

8. 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 OSI4.52±0.99 (3.00-7.30)3.41±0.78 (2.20-5.20)< 0.0001 APSI3.28±1.05 (1.40-5.70)2.63±0.54 (1.80-3.80)0.014 MLSI3.25±0.90 (2.10-4.70)2.27±0.74 (1.30-3.60)0.002 Tinetti balance 14.76±1.30 (10.00-16.00)15.70±0.77 (13.00-16.00)0.006 Tinetti gait 11.35±0.93 (9.00-12.00)11.82±0.39 (11.00-12.00)0.033 RESULTS

9. 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 Cadence 1.85±0.44 (1.11-2.64) 2.16±0.46 (1.53-3.22) 0.002 TUG 11.50±2.69 (8.16-18.45) 8.74±1.62 (6.56-12.93) < 0.0001 FR 28.41±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

10. BCVA p= OSI0.6730.003 MLSI0.5060.038 Tinetti balance-0.5510.022 Tinetti gait-0.6890.002 Gait velocity-0.6330.002 TUG-0.5660.018 No significant correlation with APSI, step length, stride length, cadence, walk base, FR RESULTS: Correlation Analysis

11. CONCLUSION These results quantitatively documented that visual acuity gain after cataract surgery improves the gait and balance scores of patients with age-related cataract