Status of fellow eye affects visual functioning improvement in bilateral cataract surgery

Surgery for bilateral cataract is associated with improved visual functioning compared with surgery for unilateral cataract when the fellow eye has a significant cataract or poor visual acuity, a study found.

These results support the “current practice of second eye cataract surgery to be considered only when the fellow eye has significant cataract or reduced presenting visual acuity,” the study authors said.

Utilizing data from the Singapore Malay Eye Study, the researchers examined the impact of bilateral or unilateral cataract surgery on visual functioning. The population-based, cross-sectional study involves 3,280 patients between the ages of 40 and 80 years; data were available for 3,225 patients for this analysis.

Patients were separated into one of four categories: bilateral cataract surgery; unilateral cataract surgery with minimal cataract in the fellow eye; unilateral cataract surgery with significant cataract in the fellow eye; and bilateral cataract.

After assessment of visual functioning, those with bilateral cataract had poorer functioning than those who had bilateral cataract surgery (P = .029). In comparing bilateral and unilateral cataract surgery, visual functioning improvements depended on the status of the fellow eye. After adjusting for confounders, improvements were seen if the fellow eye had significant cataract (P = .019) or poor visual acuity (P = .018)

“Our findings confirmed that visual acuity is the primary underlying mechanism underpinning vision-specific functioning,” the study authors said.

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Source:

Br J Ophthalmol. 2012;96(6):846-851.