Moderate evidence that second-eye cataract surgery improves vision

This systematic review found moderate evidence that second-eye cataract extraction improves stereopsis, stereoacuity, anisometropia, visual acuity, contrast sensitivity and self-reported visual functioning over and above the benefits of first-eye surgery.

However, the studies included in this review did not provide definitive evidence of second-eye surgery benefits on health-related quality of life, visual fields, falls prevention and driving performance. The authors note that the heterogeneity of outcome measures and the limited number of studies included likely contributed to these findings.

They believe this to be the first systematic review of the benefits of second-eye cataract extraction on visual function and quality of life.

The review included 10 studies judged to be of moderate or strong quality comparing vision, quality of life, visual functioning, driving and/or falls across first-eye and second-eye cataract surgery interventions in an elderly population (mean age 60 years or above), most of which used at least one objectively quantified measure.

The authors say the study’s findings are important because they show a clinical benefit that surgery in the first eye alone is unlikely to provide.

However, the impact of second-eye cataract extraction on falls prevention and driving performance remains unclear based on the studies reviewed here. They say that additional well-controlled trials must be conducted to conclusively address this issue, and recommend that the international vision research community adopt clear guidelines for measuring and reporting clinical outcome measures in a consistent manner.