Outcomes of cataract extraction in seeing eyes of functionally monocular versus completely monocular patients

To compare outcomes of cataract extraction in seeing eyes of functionally versus completely monocular patients.

Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

This study reviewed the records of patients with poor or no vision in 1 eye at the time of cataract surgery in the better-seeing fellow eye. All patients were monocular as defined by corrected distance visual acuity (CDVA) in the blind eye of 20/200 or worse. Group 1 included patients with blind-eye CDVA between light perception and 20/200 and Group 2, patients with no light perception (NLP) in the blind eye. Medical and surgical comorbidities were compared between groups. Outcome measures included CDVA, postoperative procedures, and surgical complications.

The mean number of preoperative comorbidities in operated eyes was similar between groups. The mean number of medical comorbidities in blind eyes was 2.15 +/- 0.97 (SD) in Group 1 and 1.38 +/- 1.10 in Group 2 and the mean surgical comorbidities, 0.21 +/- 0.41 and 1.28 +/- 0.68, respectively; the differences between the groups were statistically significant. At last follow-up, 19.2% of patients in Group 1 and 6.3% in Group 2 had decreased CDVA. The number of additional procedures and surgical complications was similar between groups.

Blind eyes with limited vision had more medical comorbidity and less surgical comorbidity than eyes with NLP. More patients in the former group ultimately lost CDVA in the good eye. Medical comorbidities were more likely bilateral than surgical comorbidities, predisposing to worse outcomes.