umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Ten-year longitudinal visual function and Nd: YAG laser capsulotomy rates in patients less than 65 years at cataract surgery
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
2010 (English)In: American Journal of Ophthalmology, ISSN 0002-9394, E-ISSN 1879-1891, Vol. 149, no 2, 238-244 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate the longitudinal subjective and objective visual functional results in adult cataract patients younger than 65 years at surgery. To evaluate the 10-year cumulative incidence of neodymium-yttrium-aluminum-garnet (Nd:YAG) laser treatment.

DESIGN: A prospective, longitudinal, population-based cohort study.

METHODS: The study comprised 116 patients younger than 65 years who had cataract surgery during 1 year at Norrlands University Hospital, Umeå, Sweden. Most patients (94%) had received implantation with a hydrophobic acrylic intraocular lens. Evaluated were visual acuity (VA) and visual function questionnaire (VF-14) results before and after surgery. A comparison with patients 65 years or older at surgery was made. Ten years later, 102 survivors were offered eye examinations and again asked to fill out the questionnaire. Past Nd:YAG laser treatment, as well as high- and low-contrast VA results, were analyzed.

RESULTS: Ten years postoperatively, 37% of the patients under 65 at surgery had been treated with Nd:YAG in comparison to 20% of the older patients. The cumulative incidence for not having Nd:YAG over 10 years was 72% for those under 65 and 85% for the patients 65 years or more at surgery. Eighteen percent of the younger patients had lost more than 0.1 logarithm of the minimal angle of resolution (logMAR) units of the operated eye, compared with 37% of the older (P = .00003). A reduction in VF-14 score of 10 points or more was found in 9% of the younger and 28% of the older cataract surgery patients (P = .00004).

CONCLUSION: Ten years after surgery, subjective and objective visual function remained stable in most patients younger than 65 years at surgery. More than one-third had received a posterior capsulotomy. Only a few patients with posterior capsular opacification requiring Nd:YAG were untreated at the 10-year follow-up.

Place, publisher, year, edition, pages
2010. Vol. 149, no 2, 238-244 p.
Keyword [en]
visual function, cataract surgery, longitudinal study
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
URN: urn:nbn:se:umu:diva-30345DOI: 10.1016/j.ajo.2009.08.029PubMedID: 19926068OAI: oai:DiVA.org:umu-30345DiVA: diva2:281758
Available from: 2009-12-17 Created: 2009-12-17 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Long-term outcome after cataract surgery: a longitudinal study
Open this publication in new window or tab >>Long-term outcome after cataract surgery: a longitudinal study
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Cataract surgery is the most common surgical procedure carried out in the developed world and surgery volumes have increased considerably during the last decades. Various aspects of the surgical procedure, including surgical incision size and intraocular lens materials, have changed substantially, improving the safety and the quality of the outcome. Previous research has primarily focused on the visual function results with a short follow-up time. Long-term population-based studies, exceeding a few years, presenting visual functional results postoperatively, have not been published.

Aims To determine the effects of cataract surgery on subjectively experienced visual function and visual acuity in a defined population, and compare the results between sub-groups, on a long-term basis.

Methods In this prospective, population-based investigation, all patients with presenile and senile cataract (n=810), operated on during a one-year period (1997-98), at Umeå University Hospital were included. The frequency of cataract surgery at that time, was 5.2 per 1000 population studied. Visual acuity was tested and an eye examination was performed before surgery, 4-8 weeks postoperatively, and five and ten years after surgery. Subjective visual function was assessed using self-administered questionnaires (VF-14) at all occasions. Statistical evaluations comprised analyses of variance, Mann-Whitney U-test, chi-square test, multiple linear regression, a life-table calculation, and Cox’s proportional hazard model.

Results Five years after cataract surgery, subjective and objective visual function remained stable in most patients. The most frequent cause of deterioration of visual acuity and decrease in VF-14 scores was agerelated macular degeneration (ARMD). Two thirds of the patients in the cohort were women. They were significantly older than the men and more often operated on both eyes. After adjustment for age and visual acuity, women cataract surgery patients assessed their visual function worse than men both before surgery and 4 months postoperatively. Five years after surgery these differences were no longer significant. At baseline, 13% of the patients were diabetics. At the five-year followup, subjective and objective visual function remained stable in most surviving diabetics, and the longitudinal visual function was not significantly worse compared with the non-diabetics. Ten years after surgery, 28% had received treatment for posterior capsular opacification (PCO). A significantly larger proportion of patients less than 65 years at surgery (37%) compared with those 65 years or older (20%) had been treated.

Conclusions Most patients sustain their level of visual acuity and visual function also five and ten years after cataract surgery. Ocular co-morbidity, such as ARMD, is the major cause of longitudinally reduced visual function. Patients suffering from diabetes did not have a significantly worse visual function after five years. A surprisingly large proportion of patients had received treatment for PCO after ten years.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2009. 107 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1319
Keyword
cataract, cataract surgery outcome, longitudinal study, subjective visual acuity
National Category
Ophthalmology
Research subject
Ophtalmology
Identifiers
urn:nbn:se:umu:diva-30346 (URN)978-91-7264-911-8 (ISBN)
Public defence
2010-01-22, Sal B, 9 tr, tandläkarhögskolan, 90185 Umeå, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2009-12-22 Created: 2009-12-17 Last updated: 2010-05-06Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Lundqvist, BrittaMönestam, Eva
By organisation
Ophthalmology
In the same journal
American Journal of Ophthalmology
Ophthalmology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 113 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf