Clinical Ophthalmology (Dec 2021)
Should We Perform Early Cataract Surgery? A Patient Reported Outcome Study
Abstract
Eilidh Farquhar,* Umiya Harley,* Alan Rotchford, Kanna Ramaesh Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK*These authors contributed equally to this workCorrespondence: Umiya HarleyTennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, United KingdomEmail [email protected]: Current guidance states that access to cataract surgery should not be restricted by visual acuity (VA); nevertheless, 6/12 is used as a cut-off criterion in some health institutions. This study aims to determine the benefits of performing cataract surgery in patients with VA of 6/9 or better in both eyes; determine whether these benefits change over time; and compare the benefit observed between early first eye and second eye surgery.Patients and Methods: Fifty adults with VA at least 6/9 in the worst eye and no ocular comorbidity were recruited. The Visual Function Index (VF-14) and Impact of Visual Impairment (IVI) questionnaires were conducted pre-operatively, 4 months post-operatively, and 12 months post-operatively. The t-test or a non-parametric equivalent was used to compare averages between groups.Results: The mean change in VF-14 from baseline to 4 months was 16.43 (95% CI 12.49– 20.50, p 0.05). There was no significant difference in the change in visual function between the first and second eye surgery (p > 0.05).Conclusion: This study provides evidence that visual function improves after cataract surgery in patients with pre-operative VA of 6/9 or better. The improvement observed was clinically significant and unchanged a year after surgery. Visual function improved after second eye as much as after first eye surgery. Assessing patient reported visual function may give a more realistic indication of the benefit of early cataract surgery than relying on VA alone.Keywords: visual function, cataract surgery, patient reported outcomes
