Do we operate too many cataracts?

Abstract

A questionnaire was sent to 379 patients referred for cataract extraction, asking them to assess their visual disability and their need for surgery. Two hundred and seventy‐nine patients (73.6%) answered the questionnaire, this group being representative for the 379 patients regarding all relevant variables. The patient's answers were analyzed in relation to data extracted from their referral notes (visual acuity, monocular pseudophakia, age, sex, place of residence, referring ophthalmologist). The overall level of self‐reported visual problems and need for cataract surgery were significantly correlated to a reduced best‐eye visual acuity, although the correlaion factor was low. A similar correlation between the subjective need for surgery and a worst‐eye visual acuity ≤6/24 was also found. Forty‐seven patients (16.9%) answered that cataract surgery was not needed for the time being, and this attitude was not significantly correlated to the visual acuity, provided the acuity was ≥6/24 in the best eye and ≥6/36 in the worst eye. One hundred and twenty patients (43.0%) felt that their visual disability was so severe that they had to be operated within 1 month and 67 patients (24.0%) within 3 months, while 45 patients (16.1%) felt that surgery could be postponed for at least 6 months. Age, sex, place of residence and the presence of monocular pseudophakia were not found to significantly influence the level of self‐reported visual problems. Only 18.3% preferred to be treated as out‐patients.

Cataract surgery rate in Mosul city

“…While it remained low in Eastern Mediterranean countries (7) , which is around 1000 as estimated by Allen Foster in 1997 (6) . In our study the CSR was 1098 which is similar to countries in Middle East but very low compared to developed countries as in Australia 6800, USA 5700 and UK 2700 (8) while in India 3100, South-east Asia 2400, Africa 300 and China 280 (6) . This low rate was due to many causes.…”

Clinical practice variation in cataract surgery

“…[4][5][6][7][8][9]25,53,[73][74][75][76][77] However, it must be emphasized that in the past 5 years some countries have stabilized or slightly diminished their ratios. [4][5][6][7][8][9]25,53,[73][74][75][76][77] However, it must be emphasized that in the past 5 years some countries have stabilized or slightly diminished their ratios.…”

Correlation of Dysfunctional Lens Index with Lens Opacification System III in Age Related Cataract

“…Earlier, the threshold for cataract surgery was determined by decline in visual acuity (VA), subjective evaluation of crystalline lens opacity, visual function, patient's satisfaction with pre-operative VA and surgeon's preferred practice. [6][7][8] Assessment of cataract severity encompasses several modalities such as Lens Opacities Classification System III (LOCS III), wave front analysis and Dysfunctional Lens Index (DLI). LOCS III is subjective method utilizing slitlamp biomicroscopy.…”