The decrease of visual acuity in cataract patients waiting for surgery

Abstract

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.

The consequences of waiting for cataract surgery: a systematic review

“…We present evidence that vision [6][7][8] and quality of life decreases 8,9 and that the rate of falls increases 9 among patients during the wait period. There is little empirical evidence regarding postoperative outcomes experienced by patients following different lengths of wait times.…”

“…6-32 Thirteen of these studies examined the relation between wait time and outcomes, [6][7][8][9][10][11][12][13][14][15][16][17][18] and 19 studies examined the variables that modified this relation.…”

A cost-benefit analysis of cataract surgery based on the English Longitudinal Survey of Ageing

“…annum and thus a little slower than the average deterioration shown by Leinonen and Laatikainen (1999). We draw two conclusions from these studies.…”

“…Nevertheless, as was noted earlier, even among patients selected for surgery Leinonen and Laatikainen (1999) found that 48% of patients experienced no or minimal deterioration in an average waiting time of 13 months; it is therefore possible that some of the treated patients both gained little from their surgery and also would not have deteriorated further without surgery.…”

“…No progression is found on average in the untreated American patients, while substantial and statistically significant progression is found with the Finnish patients. Nevertheless, Leinonen and Laatikainen (1999) record that over the period of one year, half the patients showed no deterioration in their eye-sight.…”