Assessing visual function behind cataract: preoperative predictive value of the Heine Lambda 100 retinometer



To analyze the accuracy of the Lambda 100 (Heine) potential visual acuity (VA) measurements in subjects undergoing cataract surgery.


The medical records of all consecutive patients who underwent clear corneal incision phacoemulsification cataract surgery by a single surgeon between 2010 and 2012 at the Department of Ophthalmology, Hadassah Medical Center, a tertiary care hospital in Jerusalem, Israel, were reviewed. Subjects age 18 or older with a follow-up time of at least 30 days were included. Subjects with previous ocular comorbidities other than glaucoma were excluded. In addition, patients with intraoperative or perioperative complications that could affect final VA were excluded. Analyses were performed to analyze the accuracy of preoperative retinometer potential VA as a predictor of postoperative best-corrected VA.


A total of 374 operated eyes were included. There was a moderate positive correlation between Lambda estimated VA potential and postoperative achieved best-corrected VA (BCVA) (β coefficient 0.35, p<0.0001). Overall Lambda accurately (within 2 Snellen lines) estimated postoperative BCVA results in 60% of cases. The accuracy of prediction was significantly better in moderate cataracts when compared with advanced cataracts (p<0.01) with a twofold tendency towards underestimation in advanced cataracts. A Lambda ≥0.5 decimal has a calculated positive predictive value of 82% and a negative predictive value of 40% for predicting postoperative BCVA outcome ≥0.5 decimal.


Lambda may be used to relatively accurately predict postoperative BCVA in cataract patients, specifically in those with moderate cataracts.

Eur J Ophthalmol 2017; 27(5): 559 - 564




Michael Mimouni, Yinon Shapira, Janan Jadon, Shahar Frenkel, Eytan Z. Blumenthal

Article History


Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.



  •  Department of Ophthalmology, Rambam Health Care Campus, Haifa - Israel
  •  Department of Ophthalmology, Hadassah University Hospital, Jerusalem - Israel
  •  School of Medicine, Technion Israel Institute of Technology, Haifa - Israel
  • Drs. Mimouni and Shapira contributed equally to this work.

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.