Outcome monitoring in cataract surgery

The short-term surgical results are reported in a consecutive series of 1473 patients undergoing cataract surgery (60% planned extracapsular cataract extraction and 40% phacoemulsification) on an out-patient basis in a major university eye clinic. Preoperatively, 80% of all cases had a visual acuity of 0.3 (6/18) or lower. On the first day after surgery, 51% of all patients had a corrected visual acuity of 0.5 (6/18) or better and 9% had a visual acuity of 1.0 (20/20) or better. The unaided visual acuity was 0.5 (6/12) or better in 20% of all patients (78% of these after phaco-emulsification). The average postoperative refraction was -0.43 D (+/- 1.03 D SD, range -6.00 D to +5.00 D). A significant improvement in refractive error was achieved in many patients. The mean intraocular lens power prediction error was found to be +0.04D (+/- 0.84D). The surgically induced astigmatism (vector analysis) was found to be +4.91D (+/- 2.08) in the extracapsular cataract extraction cases and +1.37D (+/- 1.38) in the phacoemulsification cases (p < 0.001). Capsular or zonular rupture and/or vitreous loss occurred in 43 (2.9%) of which 26 (1.8%) received an anterior chamber lens rather than the intended posterior chamber lens. The results of this study document the favorable results of modern cataract surgery.