Cataract specifics are not relevant to postsurgery improvement

Nov 21 2012

By Sarah Guy, medwireNews Reporter

Patient-reported improvements in vision after cataract surgery are high and are unrelated to the level of ocular comorbidity or whether the surgery is in the first or second eye, report researchers.

The type of cataract did not affect these subjective outcomes either, except that blurred vision was reported by patients with posterior subcapsular cataracts.

"These findings are important because they demonstrate that the benefit of cataract surgery from the patient's perspective of symptom relief is comparable for all 4 situations [first eye with or without ocular comorbidity, second eye with or without ocular comorbidity]," say Eirini Skiadaresi, from the University of Trieste in Italy, and colleagues.

"It is therefore possible that the threshold for surgery could be lowered and offered to patients with unilateral cataract or ocular comorbidity as readily as it is offered to patients with bilateral cataract and no ocular comorbidity," they add, in the Archives of Ophthalmology.

The analysis included 209 individuals undergoing cataract surgery, of whom 106 were undergoing the procedure in the first eye; 103 in the second eye.

All patients completed the Quality of Vision (QoV) questionnaire before surgery and 3 months afterwards. The questionnaire covers symptoms such as glare, halos, hazy or blurred vision, and depth-perception difficulties, and grades them in terms of frequency, severity, and bothersome nature.

Overall, participants' uncorrected distance visual acuity and corrected distance visual acuity - tested by log minimum angle of resolution - significantly improved in all four patient groups, report the researchers.

Spherical equivalent refraction also improved significantly pre- to postoperatively for all patients, except those who were undergoing first eye surgery and who had comorbidities.

Under the Lens Opacities Classification System III, more patients in each group had nuclear subcapsular cataracts than cortical or posterior subcapsular cataracts and because of the low numbers of cortical cataracts it was not possible for Skiadaresi and colleagues to correlate cataract morphology with visual symptoms in this group.

However, they observed a significant correlation between having posterior subcapsular cataracts and reporting blurred vision in the QoV.

This finding is consistent with previous research showing that posterior subcapsular cataracts cause "disproportionately more visual disability than nuclear or cortical cataracts," write the authors. "Objective cataract grading, such as lens densitometry, may have yielded better correlations," they note.

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