Cataract surgery visual outcomes uniformly good in international study

Good visual outcomes were seen after cataract surgery in several countries, despite differences in clinical practice and care delivery across countries, according to an international study in four industrialized nations.

Jens Christian Norregaard, MD, PhD, and colleagues with the International Cataract Surgery Outcomes Study group collected data from 1,073 patients who underwent unilateral cataract surgery and 211 who underwent bilateral surgery in four countries in Europe and North America.

Of the unilateral surgery patients, 570 were operated on in the United States, 111 were operated on in Manitoba, Canada; 256 were operated on in Denmark and 136 were operated on in Barcelona, Spain. Functional outcomes were assessed at 4 months postoperatively using the Visual Function Index (VF-14), a self-reported measure of visual function in which scores can range from 0 (total impairment) to 100 (no impairment). For the purposes of this study, optimal functional outcome was defined as a score of at least 95.

The country of surgery had no effect on the odds of achieving an optimal functional outcome at 4 months for the 1,073 patients who underwent unilateral surgery.

Bilateral surgery was performed in 211 patients. A postoperative VA of 0.5 or better in both eyes was reported in 155 of these patients. However, 37% of the patients with an optimal VA outcome in both eyes reported visual function impairment (a VF-14 score of less than 95), the authors said.

“We suggest that changes in visual acuity as well as in visual function be reported in any study evaluating the benefits of cataract surgery,” the authors said in a paper published in the Journal of Cataract & Refractive Surgery. Using the VF-14 might help surgeons identify visual function impairments, “especially in studies evaluating the benefits of cataract surgery in a public health setting,” they said.