Five-year change in visual acuity following cataract surgery in an older community: the Blue Mountains Eye Study

To assess the change in visual acuity following cataract surgery in the Blue Mountains Eye Study (BMES) population. Change in visual acuity was assessed by age, sex, baseline cataract type, and baseline visual acuity.

A 5-year prospective follow-up of the population-based BMES cohort, who were initially examined in 1992. After 5 years, 2335 survivors of 3654 (75.1%) baseline BMES participants were re-examined. Slit-lamp and retro-illumination lens photographs were graded for the presence of incident cataract and evidence of cataract surgery. Visual acuity was measured using a logMAR chart, read at 2.4 m. The main outcome measure was change in the number of logMAR letters correctly identified by eyes that underwent cataract surgery during the 5-year follow-up period.

In a multiple linear regression model, age (P<0.0001) and early age-related maculopathy (ARM) at baseline (P<0.0001) were found to affect adversely the postoperative visual acuity following the cataract surgery. As expected, eyes with any baseline cataract showed the greatest improvement in visual acuity after cataract surgery (right eyes: mean +/- s.e. change of 3.75 +/- 1.34 letters; left eyes: mean change +/- s.e. of 6.7 +/- 0.99 letters). There was also a statistically significant improvement in vision after cataract surgery in eyes with no significant lens opacity graded as present at baseline (right eyes: mean +/- s.e. change of 3.78 +/- 1.85 letters; left eyes: mean change +/- s.e. of 2.68 +/- 1.33 letters).

Age and baseline cataract or ARM status, and baseline visual acuity were determinants of the postoperative visual outcome in older persons who underwent cataract surgery in this community.