Preoperative and postoperative factors related to the self-assessed visual function after cataract surgery

1. Maria Kugelberg¹
2. Margrethe Rönbeck¹
3. Mats Lundström²

¹St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
²EyeNet Sweden, Blekinge Hospital, Karlskrona, Sweden

PURPOSE: To investigate if there are any pre- or postoperative factors related to the improvement in subjective visual function or subjective visual outcome after cataract surgery.

METHODS: Multicenter prospective cross-sectional Swedish National Cataract register study. During the years 2000 to 2006, 14,817 patients from 42 Swedish ophthalmology departments participated in the study. The nine questions in the Rasch analysis revised Catquest-9SF were selected from the Catquest questionnaire completed before and 6 months after cataract surgery. The Rasch analysis makes it possible to perform parametric statistics. We investigated the improvement in subjective visual function, the mean postoperative subjective visual outcome, and a global question from the postoperative questionnaire, about general satisfaction with vision.

RESULTS: We found that young age (P<0.001), low preoperative corrected distance visual acuity (CDVA) (P<0.001), high postoperative CDVA (P<0.001), no ocular comorbidity (P<0.001), and postoperative myopia (-2-0 diopters [D]) instead of hyperopia (>0-+2 D) (P<0.05) led to a significantly greater improvement in subjective visual function and a better postoperative subjective visual outcome. Women (P<0.001) and patients who had a first-eye surgery (P<0.001) had larger improvement but worse postoperative subjective visual outcome (P<0.001) than men and patients who underwent a second-eye surgery patients. The absolute biometry prediction error had no significant effect on the change in subjective visual function, the subjective mean visual outcome or satisfaction with vision.

CONCLUSIONS: Gender, first- or second-eye surgery, age, pre- and postoperative CDVA, ocular comorbidity and postoperative refraction were related to improvement in subjective visual function, subjective visual outcome and satisfaction with vision.