Comparison of the results of first and second cataract eye surgery

OBJECTIVE: To compare the outcomes of second eye cataract surgery with those of first eye surgery. In particular, to evaluate changes in visual acuity (VA), visual function, and health status after the first and second eye surgeries. DESIGN: A cohort (case series) analysis of patients recruited in a clinical trial. PARTICIPANTS: A total of 403 consecutive patients with indication of noncombined first eye or second eye cataract surgery were recruited in 3 public hospitals in Barcelona, Spain. First eye surgery patients are compared to second eye surgery patients. INTERVENTION: Patients were evaluated both before surgery and 4 months after surgery by a standardized telephone interview and clinical examination. MAIN OUTCOME MEASURES: Visual acuity, visual function index (VF-14), a 14-item instrument designed to measure visual function, and the Sickness Impact Profile (SIP), a generic measure of health status. RESULTS: Full data were obtained from 315 (78%) patients: 249 who underwent first eye surgery only and 66 different patients who underwent second eye surgery. Significant improvement was found in both groups of patients for best-corrected VA in the operated eye (4.4 Snellen lines, P < 0.001; 4.2 Snellen lines, P < 0.001, respectively), VA in the better eye (2.8 Snellen lines, P < 0.001; 1.4 Snellen lines, P < 0.001), and visual function (26.3 Snellen lines, P < 0.001; 17.0 Snellen lines; P < 0.001). Four months after the operation, the VF-14 of the second eye group was slightly better (93.4 vs. 88.5; P = 0.09; score range: 0, worst, to 100, best). Psycho-social SIP scores improved in both groups (4.8, P < 0.001; 3.1, P = 0.016). Physical SIP score improved only in the first eye surgery group (1.8, P = 0.003) but not in the second eye surgery group (-1.0, P = 0.338; score range: 0, best, to 100, worst). CONCLUSIONS: The results of our study suggest that patients undergoing second eye cataract surgery show significant improvements in VA, visual function, and psycho-social health status. However, global and physical health status does not change after second eye cataract surgery.