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K. Mazhar, A. E. Barañano, J. Wu, S. P. Azen, R. Varma, LALES Group; Causes and Risk Indicators of Visual Impairment Following Cataract Surgery in Adult Latinos: The Los Angeles Latino Eye Study(LALES).. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5451.
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To determine the primary causes, and risk indicators of visual impairment (VI) in cataract-operated eyes in adult Latinos.
Participants in LALES- a population-based cross-sectional study of adult Latinos aged 40 years and older residing in Los Angeles, California -underwent in-home interview and a comprehensive ophthalmologic examination. VI in the cataract-operated eye was defined by: presenting visual acuity (PVA) ≤20/40 or best corrected visual acuity (BCVA) ≤20/40. Uncorrected refractive error in cataract operated eye was defined as visual acuity ≤20/40 by PVA but visual acuity >20/40 by BCVA. The primary cause of VI was assigned to the condition expected to cause the greatest limitation of vision in the cataract-operated eye based on clinical examination findings, lens grading, fundus photographs, and all information provided by the examining ophthalmologist. Stepwise logistic regression evaluated the socio-demographic and clinical variables as risk indicators associated with VI by BCVA in the worse seeing cataract-operated eye.
The analyses include 261 participants with at least one cataract extraction and complete clinical examination data. There were 100 participants with unilateral and 161 with bilateral cataract extractions. Of the 422 cataract operated eyes, 203 (48%) had VI defined by PVA compared to 136 (32%) by BCVA. Uncorrected refractive error (33%), age related macular degeneration (13%), diabetic retinopathy (11%), corneal opacity (8%), posterior capsular opacification (7%), glaucoma (5%), myopic degeneration (4%) and retinal detachment (3%) were the major causes of VI in cataract-operated eyes. Self-reported history of glaucoma (OR=2.9, CI=1.3-6.7), barriers to eye care (OR=2.6, CI=1.1-6.2), and unmarried or not living with partner (OR=1.9, CI=1.01-3.4) were independent factors associated with VI in cataract-operated eyes (p <0.05).
There remains a significant degree of VI after cataract extraction in adult Latinos. Many of the underlying causes of this VI are amenable to improvement or correction by careful clinical follow-up. Creating a program that facilitates access to ophthalmic healthcare services would address many of the causes of VI in cataract-operated adult Latinos.
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