Longitudinal changes in subjective and objective visual function 5 years after cataract surgery

Abstract

To investigate the long-term outcomes of cataract surgery by analyzing data collected 5 years after surgery and comparing with preoperative and postoperative subjective and objective visual function results. Norrlands University Hospital, Umeå, Sweden. A prospective longitudinal population-based cohort study comprised 810 patients who had cataract surgery during a 1-year period within a geographically defined area. Evaluated were visual acuity data and Visual Function-14 questionnaire (VF-14) results before and after surgery. Five years later, the 590 patients still alive were offered eye examinations and asked to fill out the questionnaire. Of the 590 patients asked to participate at 5 years, 530 answered the questionnaire and 467 had eye examinations. The median VF-14 total score for all patients after surgery was 100; at 5 years, the score decreased to 96.7 (P = .001). Five years after surgery, 46% of patients had unchanged or better visual acuity in the operated eye, 37% had lost more than 0.1 logMAR unit, and 22% had a reduction in VF-14 score of 10 points or more. The two main reasons for the decline in visual acuity and VF-14 scores were age-related macular degeneration (ARMD) (47% and 60%, respectively) and glaucoma (12% and 11%, respectively). Age, co-morbidity, and VF-14 scores after surgery were independently associated with the VF-14 score 5 years after surgery. Subjective and objective visual function 5 years after cataract surgery remained stable in most patients. Co-morbidity, most commonly ARMD, was the most frequent cause of deterioration of visual acuity and decrease in VF-14 scores. Age and co-morbidity were independently associated with the VF-14 score 5 years after surgery.