Results of cataract surgery in the very elderly population

Abstract

AimThe aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older, whom we define as “very elderly.”MethodsThe study involved a total number of 122 patients (122 eyes) with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old). Phacoemulsification (phaco) was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery.ResultsBest corrected visual acuity (BCVA) improved in 100 of 122 eyes (82.0%). BCVA remained the same in 20 of 122 eyes (16.4%) and decreased in 2 of 122 eyes (1.6%), mainly because of coexisting age-related macular degeneration (AMD). The BCVA 3 months after surgery was ≥0.8 in 23 of 122 eyes (18.9%), between 0.5 and 0.7 in 28 of 122 eyes (22.3%), and between 0.2 and 0.4 in 33 of 122 eyes (27.1%). We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma.ConclusionAdvanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with IOL for very elderly patients are effective and safe.

The Royal College of Ophthalmologists’ National Ophthalmology Database Study of cataract surgery. Report 5: Clinical outcome and risk factors for posterior capsule rupture and visual acuity loss following cataract surgery in patients aged 90 years and older

“…Previous smaller studies on elderly people have reported similar visual changes. Michalska et al, (22) in their study of 122 operations on patients over 90 years of age, reported that postoperative VA improved in 84% eyes, remained the same in 16% eyes and deteriorated in 1.6% eyes, this deterioration being attributed in 62% of the cases to the underlying advanced AMD. The figure of 84% for VA improvement in this small study was virtually identical to the 85% reported here.…”

Visual acuity improvement after phacoemulsification cataract surgery in patients aged ≥90 years

“…A more recent report found no difference in postoperative VA between 31 eyes of patients aged ≥90 years and 70 eyes of patients aged < 90 years [ 13 ]. Other recent studies also have shown favorable VA outcomes after cataract surgery in patients aged ≥90 years, though without comparison to younger patients [ 14 , 15 ]. Another limitation is that these previous studies have used postoperative VA as an outcome measure, but not improvement in postoperative VA.…”

Reasons for delay of surgical treatment among patients with senile mature cataract in Goa

“…5 Despite rapid increase in the availability of quality cataract services, however, surgical acceptance is still low in the community. [1][2][3][4][5][6] Studies have shown that availability of eye care services may not necessarily translate into their effective and adequate utilisation. 7 For example, in the state of Goa, ours is a government funded tertiary care centre providing cataract surgery services.…”

“…Studies have shown that when systemic conditions are stable, both phacoemulsification and Extra-capsular cataract extraction (ECCE) with intraocular lens (IOL) implantation for very elderly patients are effective and safe. 4 However, with an earlier treatment, better visual outcomes would become more achievable even in those with co-existing ocular and systemic illnesses.…”

“…The decrease of vision is a serious health risk for challenges of loss of balance, perhaps leading to falls and injury, along with lack of self-sufficiency, dependency, and decreased work productivity. 4 As a result of the large population base and increased life expectancy, the number of visually impaired particularly due to age-related disorders such as cataract is expected to rise.3 With the current trend of population 'greying' in both developed and developing nations, the percentage of elderly is expected to increase manifold, with a ABSTRACT Background: Cataract accounts for about 81% of blindness in India. By 2020, the elderly population is expected to double, further increasing the number of visually impaired.…”