Purpose: To determine the accuracy of predicting potential visual acui
ty in patients having neodymium:YAG (Nd:YAG) laser capsulotomy using a
new device, the illuminated near card (INC). Setting: Private practic
e, New York, New York. Methods: Thirty-eight consecutive patients havi
ng Nd:YAG laser capsulotomy were studied prospectively by comparing th
e postoperative distance Snellen acuity to the visual acuity obtained
preoperatively using (1) a near vision reading card, (2) the INC, and
(3) the INC viewed through a pinhole. Results: Patients reported that
the INC was easy to use; none with a visual acuity better than 20/200
had difficulty finding the illuminated letters through the pinhole. In
eyes with a precapsulotomy distance acuity of better than 20/200, the
correlation between precapsulotomy and postcapsulotomy acuities was s
tatistically significant (P < .001) for the INC viewed through the pin
hole. A significant correlation between precapsulotomy and postoperati
ve acuities was not found for the INC viewed alone or for the near car
d (P > .05). In patients with a precapsulotomy distance acuity of 20/2
00 or worse, the INC with pinhole, the INC, or the near card did not p
redict postoperative acuity (P > .05). Conclusion: In eyes with a prec
apsulotomy distance acuity better than 20/200, the INC with pinhole pr
edicted postoperative distance acuity within one Snellen line in 97% o
f eyes (29/30), which is comparable to reports using other potential a
cuity testers. The INC viewed through a pinhole improves image resolut
ion by the stenopaic hole without the low light intensity of the reduc
ed aperture.