Visual Acuity Outcomes after Phacoemulsification in Eyes with Good Visual Acuity before Cataract Surgery

Abstract

Objective: To analyze cataract surgery outcomes and related factors in eyes presenting with good visual acuity. Subject and Methods: Retrospective longitudinal of patients undergoing phacoemulsification between the years 2014-2018 in Moorfields Eye Hospital and satellite units. Pre- and postoperative visual acuity (unaided, with glasses, with pinhole) were analyzed. Inclusion criteria were age≥40 years and pinhole visual acuity ≥6/9 preoperatively. Exclusion criteria were no postoperative visual acuity data. VA change variable was also defined according to postoperative visual acuity being above or below the Snellen 6/9 threshold. Results: 2720 eyes were included in the analysis. The unaided LogMAR visual acuity improved from 0.54 to 0.20 (p<0.001), the LogMAR visual acuity with glasses improved from 0.35 to 0.05(p<0.001) and the LogMAR pinhole visual acuity improved from 0.17 to 0.13(p<0.001). 8.1% of patients had Snellen visual acuity <6/9 postoperatively. Mean follow up period was 23,6±9.9 days. In multivariate logistic regression, factors associated with visual acuity <6/9 postoperatively were: age [OR=0.96, 95% CI (0.95, 0.98), p<0.001], vitreous loss [OR=0.21, 95% CI (0.08, 0.56), p=0.002] and iris trauma [OR=0.28, 95% CI (0.10, 0.82) p=0.02]. No significant adverse events occurred. Conclusions: Visual acuity improved significantly overall in this group of patients, although at least 8.1% of them did not reach their pinhole preoperative visual acuity. Worse visual acuity outcomes were associated with increasing age, vitreous loss and iris trauma. The 6/9 vision threshold may not be able to accurately differentiate those who may benefit from cataract surgery and those who may not.

Postoperative vision outcomes after cataract surgery in the Eastern region of Ghana

“…Consistent with several published studies [14,[30][31][32] our study showed a signi cant association between postoperative surgical complications and poor visual outcomes. More precisely, persons with complications after surgery were four times more likely to experience low visual outcomes.…”

“…A multiple regression analysis by Khanna et al revealed that patients with postoperative complications (POC) were two times more likely to experience worsen visual outcome [14]. Similarly, Dervenis and coworkers observed that persons that suffered postsurgical complications such as vitreous loss had a signi cantly compromised postoperative visual acuity with reduced outcomes [30]. Likewise, Mimouni et al, demonstrated an independent association between preexisting postoperative complications and poor vision outcomes [31].…”

Incidence and Risk Factors for Retinal Detachment Following Cataract Surgery at a Tertiary Center in Jeddah, Saudi Arabia

“…In our study, mean visual acuity improved from 20/80 preoperatively to 20/60 on postoperative Day 1 and to 20/40 thereafter. A study conducted at Moorfield Eye Hospital reported that visual acuity improved from 0.5 (20/60) to 0.2 (20/30), similar to our findings [ 18 ]. Another cross-sectional study assessed the difference in visual acuity between patients with and without diabetes, reporting that 87% of those with diabetes achieved normal vision (20/20 to 20/60) on postoperative Day 1, in contrast to 92% of those without diabetes.…”

The Effect of Cataract Surgery on the Risk of Dementia: A Nationwide Cohort Study

“…However, an increasing age is associated with worse VA outcomes following cataract surgery. With each additional year of age, the patients had a 0.96-fold lower likelihood of attaining a VA of ≥6/9 on the Snellen chart [21]. Although our study did not compare the VA before and after surgery, our study suggests that cataract surgery should be recommended at a proper time.…”