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Eva Monestam; Long-time outcome of cataract surgery - 15 year results from a prospective study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2539.
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© ARVO (1962-2015); The Authors (2016-present)
To report the changes in visual acuity (VA) and subjective visual function, from postoperatively to 15 years after cataract surgery.
This population-based prospective study reviewed 190 patients (83% of survivors), who underwent cataract surgery during a 1-year period 15 years previously (1997-98). All patients answered the same visual function questionnaire (VF-14) preoperatively, 4 months postoperatively, 5, 10 and 15 years after surgery. The majority of the patients (88% 168/190;74% of survivors) also had a routine eye examination including best corrected VA and low contrast VA 10% and 2,5%.
Fifteen years after surgery the BCVA of the operated eye had deteriorated to a median of 0.1 (logMAR) (Snellen acuity: 20/25) from 0.0 (logMAR) (20/20) postoperatively, (p=0.0001). Sixty percent of the patients had less than 0.1 logMAR units worsening of BCVA compared with postoperatively. Eight percent of the patients (14/168) had worse BCVA 15 years after surgery compared with the preoperative VA. Fifty-four percent (103/190) had no deterioration in subjective visual function (questionnaire), and 79% (150/190) had 10 points decline or less. Eleven percent of the patients (22/190) had a worsening of more than 30 points. Twelve percent of the patients (23/190) had no surgery of the fellow eye.
These results confirm the effectiveness of cataract extraction, offering good long-term visual rehabilitation for the majority of the patients. The extent and distribution of loss in subjective visual function is comparable to the outcome 10 years after surgery. The median VA is three letters lower compared with 10 years after surgery, which can be explained by aging of the cohort. The most common cause for large functional loss 15 years after cataract surgery is age-related macular degeneration, the same as 10 years after surgery.
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