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E. Monestam, B. Lundqvist; Longitudinal Visual Outcome 10-Years After Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5391.
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This prospective, population-based cohort study reports the longitudinal visual functional outcome of cataract surgery on a long-term basis. Data collected pre- and postoperatively, as well as 5 and 10 years after surgery from the same patients is analyzed.
810 participants underwent cataract surgery during a 1-year period. Before surgery, a few months after surgery, and 5 and 10 years after surgery, age and comorbidity were recorded, and BCVA was measured. At all occasions the patients also answered the same visual functional questionnaire (VF-14). Ten years after surgery 335 (85% of survivors) participated with the questionnaire of whom 289 (73% of survivors) were re-examined.
Ten years after surgery 76% of the patients examined had a BCVA of 20/40 or better, and 65% had a BCVA of 20/30 or better, which is a decline from 88% and 84% after surgery, respectively. Regarding each operated eye, 50% had unchanged or better VA, and an additional 19% had only lost less than 0.1 logMAR units, compared with postoperatively. Forty-six patients (16%) had a decline in BCVA of more than 0.3 logMar units.The median VF-14-total score was 100 after surgery, declining to 96.7 5 years after surgery, and to 96.4 10 years after surgery. Ten years after surgery 49% of the patients had unchanged or better subjective visual function and 77% had less than 10 points in decline compared with preoperatively. Nine percent (31 of 335 patients) had a worsening of VF-14 total score of 40 points or more. In this group age-related macular degeneration (ARM) was the most common cause followed by bullous keratopathy. Only 18% of the patients in this cohort had an unoperated fellow eye 10 years after surgery.
Longitudinal follow-up of this older population confirms that subjective and objective visual function 10 years after cataract surgery remains stable in most surviving patients. Cataract surgery offers good long-term visual rehabilitation for cataract. Comorbidity, most commonly ARM but also bullous keratopathy, are the most important causes for deterioration of visual function.
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