Outcomes of cataract extraction in functionally monocular patients: Case-control study

Abstract

Purpose To compare the ocular comorbidities, visual outcomes, and surgical complications between a series of functionally monocular patients who had phacoemulsification and intraocular lens (IOL) implantation and a control group of age- and sex-matched binocular patients. Setting: Jules Stein Eye Institute and the Department of Ophthalmology, UCLA School of Medicine, Los Angeles, California, USA. Methods The records of a consecutive series of 100 functionally monocular patients who had phacoemulsification and IOL implantation were reviewed. The records of a control group of binocularly sighted patients who were matched to the monocular patients by age, sex, and date of surgery were also reviewed. Results Thirteen patients in the monocular group were monocular because of surgical complications. The remaining patients (87%) were monocular from medical conditions. Monocular patients had significantly more ocular comorbidity than binocular control patients ( P < .0001). Age-related macular degeneration, diabetic retinopathy, and open-angle glaucoma were the most common reasons for monocular status and the most common ocular comorbidities in study eyes. The median preoperative best corrected visual acuity (BCVA) was 20/50 in the monocular group and 20/40 in the binocular group. The median postoperative BCVA was 20/25 and 20/20, respectively. A final BCVA of 20/40 or worse was the result of preexisting macular pathology or glaucoma in every instance. Surgical complications ( P = .096) and the number of postoperative procedures ( P = .724) were similar between the 2 groups. Conclusions Ocular comorbidity was significantly more prevalent in the eyes of monocular patients. Monocular and binocular patients experienced a 3-line improvement in BCVA after cataract surgery; however, the final median acuity was 20/25 in the monocular group and 20/20 in the binocular group. The 2 groups had a similar complication rate.