Factors affecting the visual outcome after cataract surgery

Lumme, Pirkko; Laatikainen, Leila

doi:10.1007/bf00915736

Cited by 16 publications

(12 citation statements)

References 23 publications

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“…Older patients lose a greater part of their remaining years. This could be a reason to operate older patients sooner, although the results of cataract extraction on the older patients are more often unsatisfactory (Lumme & Laatikainen 1993). On the other hand, for the younger patients surgery may help to preserve or return the working capacity.…”

Section: Discussionmentioning

confidence: 99%

The decrease of visual acuity in cataract patients waiting for surgery

Leinonen

Laatikainen

1999

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To investigate the rapidity of vision loss in eyes waiting for cataract surgery and to estimate what proportion of life expectancy the extended wait for surgery comprised. Methods:The visual acuities at the time of referral and on the day before surgery were compared in 124 patients operated on for cataract in the Vaasa Central Hospital, Finland. The expected survival of the patients after surgery was calculated individually using the Finnish life statistics. Results: During the waiting time of 13 months on the average, the visual acuity in the study eye decreased from 0.68 logMAR (0.2 in decimal values) to 0.96 logMAR (0.1). The average decrease in vision was 0.27 logMAR per year varying from none to 2.07 logMAR units. 30% of the eyes experienced worsening of vision by 60% or more while 48% had no or minimal worsening (∞0.2 log-MAR). The rapidity of change in visual acuity was somewhat less in older patients (75 years or older), but the difference was not statistically significant. The percentage of persons with visual acuity of 0.5 or better in the better eye decreased from 66% to 41% and those with low vision (∞0.3 in the better eye) increased from 8% to 21%. The mean waiting time in relation to the expected survival for all patients was 13% varying from less than 5% in 10 patients to more than 25% in 8 patients. Conclusion: Progression of vision loss in eyes waiting for cataract surgery varies significantly. For many patients the extended delay caused remarkable disability for a considerable part of their remaining lifetime.

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Section: Discussionmentioning

confidence: 99%

The decrease of visual acuity in cataract patients waiting for surgery

Leinonen

Laatikainen

1999

Acta Ophthalmologica Scandinavica

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“…These figures are in accord with those the National Cataract Survey (UK) 9 16 but are rather lower than epidemiological prevalence data would suggest for this age group 1 2 and the figure of 33% of cataract cases with ARM identified in a study from Finland. 13 The proportion of eyes with severe (active or inactive exudative) ARM (2% or 0.2% of all notes reviewed) was also a great deal lower than epidemiological prevalence figures (5.2% 1 in those over 75 years and 7.4% in those over 85 years 22 ) and the same Finnish study (4.2%). 13 These findings suggest that our sample represents a selected population of patients with ARM, possibly reflecting diVering access to ophthalmic services (for example, primary carers may attribute poor vision to the presence of known ARM rather than to the development of a cataract) or diVering thresholds for, or expectations from, cataract surgery in patients with ARM (ophthalmologists may be reluctant to operate on those with ARM, particularly those with severe disease, on the grounds that they do not anticipate improvement in acuity).…”

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confidence: 85%

“…Although previous investigators have identified factors associated with poor outcome following cataract surgery, including the patient age and ocular co-morbidity (especially ARM), [9][10][11][12][13][14][15][16] none has addressed specifically the benefits of surgery in these high risk groups.…”

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confidence: 99%

Do patients with age related maculopathy and cataract benefit from cataract surgery?

AMBRECHT¹,

FINDLAY²,

ASPINALL³

et al. 1999

British Journal of Ophthalmology

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Aims-To assess the benefits of cataract extraction in patients with age related maculopathy (ARM). Methods-1073 randomly selected cataract operations were reviewed and 99 cases of preoperatively recognised ARM were identified for investigation. Data relating to visual function were retrieved from case notes, and patient responses to a questionnaire were analysed. Results-98% had dry or unspecified ARM. Only 2% had exudative maculopathy. 81% of cases had an improvement in best distance acuity; mean change 0.44 logMAR (change of 6/36 to 6/12). 65% responded to the questionnaire; 67% felt that the operation had been worthwhile, 17% had mixed feelings, and 17% thought it not worthwhile. Conclusion-This study, which is the first of its kind to be reported, shows a clear benefit from cataract surgery in the majority of patients with ARM. However, the prevalence of ARM in this study is lower than expected, suggesting that some patients with both ARM and cataract were not listed for surgery. The design of a prospective study to quantify the subjective and objective benefits of cataract surgery in these patients is outlined and predictors of successful outcome identified. This will promote the development of guidelines for the surgical management of this group of patients. (Br J Ophthalmol 1998;82:611-616) Age related maculopathy (ARM) aVects approximately 40% of those over the age of 75 years.1 2 It is the most common maculopathy to aVect individuals with cataract, the two conditions occurring with increasing frequency with age.3 4 ARM currently contributes to around 50% of all those registered as blind and partially sighted in England and Wales 5 and a recent study has suggested that the condition may be becoming more prevalent. Although this proportion is rather lower than would be expected from prevalence data, this still constitutes around 100 000 operations in the USA and 10 000 operations in the UK each year. When treating a patient with ARM and cataract the clinician must decide whether cataract surgery will be of benefit, a decision that is often diYcult to make. Sometimes the patient is listed for surgery on the grounds that there is little to lose. However, the constraints of tight budgets and waiting lists, and the need to target resources, means that medical practice must be evidence based and it is therefore necessary to have reliable data to support the decision of whether or not to operate.Although previous investigators have identified factors associated with poor outcome following cataract surgery, including the patient age and ocular co-morbidity (especially ARM), 9-16 none has addressed specifically the benefits of surgery in these high risk groups.We have performed a retrospective analysis of case notes and circulated a self completion questionnaire in order to determine whether patients with ARM benefit from cataract surgery both in terms of visual function and patient satisfaction. In addition, we attempted to identify predictors of benefit and to determine whether we are operating on ap...

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“…In recent years, the number of people who undergo cataract surgery has increased rapidly and it becomes the most frequently performed cost-effective surgical procedure throughout the world. [4][5][6] The outcome of cataract surgery for an individual or for a defined population is therefore as important as measuring the quantity of surgical operations performed. The outcome of cataract surgery can be measured through postoperative level of visual acuity, ability to function, quality of life, and economic rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

“…20,21 Previous studies have shown that surgically induced uncorrected refractive error was the most common cause of poor visual outcome after operation. 20 Overall, this study implicates that greater effort should be exerted to identify the main cause of visual impairment after operation and to devise strategies so as to maximize the level of visual outcome.…”

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confidence: 99%

Visual Outcome of Cataract Surgery At Gondar University Hospital Tertiary Eye Care and Training Center, North West Ethiopia

Seid

2017

Value in Health

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Background: Globally, cataract is the leading cause of blindness which accounts for 51% of 39 million blind people. The visual rehabilitation is made through sight-restoring surgery. The patients' postoperative visual satisfaction, vision related quality of life, ability to function in daily activities and their overall productivity mainly depend on the visual outcome. However, there are limited data on the visual outcome and its associated factors in the study area. Therefore, this study intended to evaluate the postoperative level of visual acuity to provide a baseline information regarding visual outcome and design a standardized protocol to maximize it. Methods and materials: A hospital-based cross-sectional study was conducted at the Gondar University Hospital Tertiary Eye Care and Training Center on 223 patients who underwent cataract surgery, selected using simple random technique from April to June 2015.Results: This study consisted of 218 patients or eyes that underwent cataract surgery. The median age of the participants was 65 years with an interquartile range of 20 years. Of 218 cataract-operated visually impaired eyes (<6/60), 26.6% of them achieved good visual acuity (≥6/18), 28.9% of them had borderline acuity (<6/18-6/60), and the remaining of 44.5% were remained as poor visual acuity (<6/60). It has been observed that the postoperative visual acuity had an association with postoperative follow up time duration (P=0.035).

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Factors affecting the visual outcome after cataract surgery

Cited by 16 publications

References 23 publications

The decrease of visual acuity in cataract patients waiting for surgery

The decrease of visual acuity in cataract patients waiting for surgery

Do patients with age related maculopathy and cataract benefit from cataract surgery?

Visual Outcome of Cataract Surgery At Gondar University Hospital Tertiary Eye Care and Training Center, North West Ethiopia

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