JUL 01, 2013
Cataract/Anterior Segment
This study analyzed data from close to 370,000 cataract extractions performed in Europe and found that visual outcomes were excellent, with 61 percent of patients achieving a corrected distance visual acuity (CDVA) of 1.0 (20/20) or better. While age and sex influenced visual outcomes, the greatest influences were short-term postoperative complications, ocular comorbidity, surgical complications and complex surgery.
CDVA improved in 92.6 percent of patients and worsened in 1.7 percent after surgery. Among patients with 20/20 CDVA before surgery and an ocular comorbidity, CDVA worsened in approximately 25 percent after surgery.
The authors analyzed data from 368,256 cataract extractions performed in 15 European countries, drawn from the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. The timeframe for postoperative complications considered in the study was until 60 days after surgery.
The best visual outcome was achieved in patients aged 40 to 74 years. Men showed a higher percentage of excellent vision of 20/20 or better than women after surgery. CDVA of 0.5 (20/40) or better was achieved in 94.3 percent of cases. Deterioration of visual acuity after surgery was most common in patients with a good preoperative visual acuity.
Previous vitrectomy, corneal opacities and white cataract were most associated with worse visual outcomes. Surgical complications most related to worse visual outcomes were dropped nucleus, vitreous loss and capsule complication.
The authors say that a weakness of the study could be that some of the data is self-reported to the registry. They emphasize the importance of avoiding capsule complications during surgery because they are related to poor visual outcomes; therefore, they recommend matching the experience of the surgeon to the expected complexity of the surgery.