2020–2021 BCSC Basic and Clinical Science Course™
11 Lens and Cataract
Chapter 8: Phacoemulsification for Cataract Extraction
Outcomes of Cataract Surgery
Modern cataract surgery usually improves visual acuity and enhances subjective visual function. More than 90% of otherwise healthy eyes achieve a best-corrected visual acuity of 20/40 or better after surgery. When eyes with comorbid conditions such as diabetic retinopathy, glaucoma, and age-related macular degeneration are included, these rates are reported to be 85%–89%. A study of a large multicenter European database reported that approximately 93% of eyes achieved a postoperative spherical equivalent within 1.00 D of that predicted by preoperative biometry.
However, visual acuity is only 1 measure of the functional success of cataract surgery. Research tools have also been developed to assess how cataract progression and cataract surgery affect visual function (see Chapter 6). Prospective studies using these tools have shown that patients who undergo cataract surgery have substantial improvement in many quality-of-life parameters, including performance of activities in the community and the home, number of falls, mental health, driving ability, and life satisfaction.
Jaycock P, Johnston RL, Taylor H, et al. The Cataract National Dataset electronic multi-centre audit of 55,567 operations: updating benchmark standards of care in the United Kingdom and internationally. Eye (Lond). 2009;23(1):38–49.
Lundström M, Dickman M, Henry Y, et al. Risk factors for refractive error after cataract surgery: analysis of 282, 811 cataract extractions reported to the European Registry of Quality Outcomes for cataract and refractive surgery. J Cataract Refract Surg. 2018;44(4):447–452.
Melles RB, Holladay JT, Chang WJ. Accuracy of intraocular lens calculation formulas. Ophthalmology. 2018;125(2):169–178.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.