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Anna C. Tan, Judy Park, Zheng Ying Feng, Tien Y. Wong, Tin Aung, Seang-Mei Saw, Ecosse L. Lamoureux; The Impact Of Cataract Surgery On Visual Function In An Asian Population: The Singapore Malay Eye Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2793.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the impact of significant cataract and cataract surgery on visual functioning in an Asian population.
The Singapore Malay Eye Study (SiMES) is a population-based study of 3,280 Singapore Malays aged 40-80 years. Study subjects were categorised as: a) Bilateral cataract surgery performed; b) Unilateral cataract surgery performed with minimal cataract in the other eye; c) Unilateral cataract surgery performed with a significant cataract the other eye; and d) Bilateral cataract. Visual functioning was assessed using the revised VF-11 scale culturally adapted for use in Singapore. Rasch analysis was used to validate the VF-11 and generate stable linear person measures. In linear regression models, the overall Rasch-transformed al vision-specific functioning score was compared across the four groups after adjusting for confounders like age, sex systemic and ocular co-morbidities.
Persons with bilateral cataract (d) had poorer visual functioning (VF) than those who bilateral cataract surgery (a) (mean VF scores= 2.86 vs. 3.33, respectively, p=0.038). When those with bilateral cataract surgery were compared to those with unilateral cataract surgery (b) and (c), differences in functioning varied depending on the fellow eye. If the fellow eye had significant cataract, (c), the persons with bilateral cataract surgery had better VF (mean VF scores= 3.05 vs. 3.57, p=0.042) after adjusting for confounders. However if the fellow eye had only minimal cataract (b), persons with bilateral cataract surgery (a) had worse VF score (mean VF scores 4.32 vs. 3.62, p=0.012).
There was an improvement in VF after bilateral cataract surgery as compared to subjects with un-operated bilateral significant cataract. Comparing bilateral with unilateral cataract surgery, VF score only improved when the fellow eye had a significant cataract. Our findings in this population-based study of Singaporeans of Malay ethnicity reinforce the public health message of the benefits of either single or bilateral cataract surgery on vision-specific functioning.
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