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E.S. West, B. Munoz, A.T. Broman, S.K. West; Effects of Cataract Surgery on Measured and Perceived Function in the SEE Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4726.
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© ARVO (1962-2015); The Authors (2016-present)
Cataract extraction is the most commonly performed surgical procedure in the United States. While improvements in visual acuity have been widely reported, little research has evaluated whether this improvement is associated with improved performance on tasks of daily living and perceived visual abilities.
All participants in the Salisbury Eye Evaluation Study who had not undergone cataract surgery at baseline were included in this study. At baseline and two–year follow up visual acuity, glare and contrast sensitivity were measured and participants completed several performance–based tasks including reading standardized text, a timed 4–m walk, ascending and descending stairs, and getting out of a chair and stepping away. Perceived visual disability was measured using the Activities of Daily Living Scale (ADVS).
1815 subjects without cataract surgery in either eye at baseline were seen at both baseline and two years. Among these subjects, 29 reported bilateral surgery between baseline and follow up. An additional 90 individuals underwent unilateral surgery during this time. Regardless of whether cataract surgery was unilateral or bilateral, surgery was associated with improved better eye visual acuity (p<0.001) and contrast sensitivity (p<0.001). Surgery was not associated with improved glare sensitivity. Both bilateral and unilateral cataract surgery were associated with improved reading speed compared to subjects who did not undergo cataract surgery (17.6 words per minute increase, p=0.002 and 12.0 wpm, p <0.001 respectively). Interestingly, after adjusting for age and comorbidities, bilateral surgery was not associated with a change in performance speed on tasks of daily living (p=0.38); however, unilateral surgery was associated with decreased performance compared to subjects not undergoing cataract surgery (p=0.01). Additionally, bilateral surgery was associated with improved ADVS scores (+6.9 pts, p = 0.0009) while unilateral surgery patients reported slight decreased ADVS scores compared to patients not undergoing surgery (–3.0 pts, p=0.04).
These data suggest that while cataract surgery improves reading speed and acuity, unilateral surgery is associated with a slight decrease in speed for performing tasks of daily living and increased self–reported visual disability. These data suggest that when second eye cataract surgery is warranted, it should be performed as soon after first eye surgery in order to improve performance on activities of daily living. Additional research is needed to further evaluate this association.
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