Intermediate- and longer-term visual outcomes after cataract surgery: the Blue Mountains Eye Study

Abstract

Limited data are available on long-term cataract surgical outcomes. We aimed to compare intermediate-term (up to 5 years) and longer-term (5-10 years) post-surgery visual outcomes in an older Australian population. Population-based cohort. Persons aged 49+ years, living in the Blue Mountains area, west of Sydney. Of 3654 baseline participants of Blue Mountains Eye Study, 75% of survivors were seen at each of the 5- and 10-year follow-up visits; 90 participants (130 eyes) underwent incident cataract surgery during the first 5 years and returned to both follow-up visits. Changes in visual acuity over time, and ocular conditions affecting visual acuity. After the first (intermediate-term) follow-up period, 33/128 eyes (26%) had presenting visual acuity <6/12. Similarly, after the second (longer-term) period, 27/119 eyes (23%) had presenting visual acuity <6/12. Uncorrected refractive error accounted for 22/33 eyes (66%) with reduced presenting visual acuity at the intermediate term and for 16/27 eyes (59%) at the longer-term follow-up visits. Of 10 eyes with reduced best-corrected visual acuity after longer term, five (50%) were attributed to posterior capsular opacification. Of 115 eyes with refractive error data, 82 (71%) and 70 (61%) were emmetropic, at the intermediate-term and longer-term visits, respectively. Over a longer term post cataract surgery, three quarters of eyes achieved presenting visual acuity ≥6/12 and nearly two-thirds achieved emmetropia. Uncorrected refractive error and posterior capsular opacification were the main causes of poor vision in operated eyes, a finding emphasizing the need for ongoing eye care services post cataract surgery.