Extended long‐term outcomes of cataract surgery

Purpose: To longitudinally report the changes in visual acuity (VA) and subjective visual function, 10 years after cataract surgery. Methods: This population‐based prospective study reviewed 335 patients (85% of survivors) who underwent cataract surgery during a 1‐year period in 1997–98, 289 of whom were also re‐examined. The patients underwent a routine eye examination and answered the same visual function questionnaire (VF‐14), preoperatively, 4 months postoperatively, 5 years and 10 years after surgery. Results: Ten years after surgery, the best corrected VA (BCVA) of the operated eye had deteriorated to a median of 0.06 (logMAR) (Snellen acuity: 20/23) from 0.046 (logMAR) (20/22) postoperatively (p = 0.001). More than two‐thirds of the patients had <0.1 logMAR units worsening of BCVA compared with postoperatively. Approximately half of the patients had no deterioration in subjective visual function, and 77% had 10 points decline or less. Twelve per cent of the patients (42/335) had a worsening of more than 30 points. Effect size was calculated for the VF‐14 total score at all three occasions of follow‐up after surgery and was largest approximately 4 months postoperatively. Long‐time follow‐up of 10 years shows still moderate effect size. Conclusion: These results confirm the effectiveness of cataract extraction, offering good long‐term visual rehabilitation for the majority of the patients. The most common cause for large functional loss after 10 years is age‐related macular degeneration.