Severe Vision Loss Following Cataract Surgery: An Analysis Of 1.7 Million Eyes From The United Kingdom National Ophthalmology Database
Published 2026 - 44th Congress of the ESCRS
Reference: FP09.04 | Type: Free paper | DOI: 10.82333/5kj8-1p76
Authors: Dr Conor Ramsden* 1 , Dr Charlotte Norridge 2 , Mr Sunil Mamtora 3 , Mr Paul Donachie 2 , Dr John Buchan 4
1Royal Devon University Hospitals,Exeter,United Kingdom, 2Royal College of Ophthalmologists,London,United Kingdom, 3Bristol Eye Hospital,Bristol,United Kingdom, 4Royal College of Ophthalmologists,London,United Kingdom;The Leeds Teaching Hospital,Leeds,United Kingdom;International Centre for Eye Health, London School of Hygiene and Tropical Medicine,London,United Kingdom
Purpose
To investigate rates of severe vision loss post-cataract surgery.
Setting
Between 2010 and 2024, there were 1 750 553 eligible operations performed on 1 217 267 patients by 3 766 surgeons from 132 centres supplying data to the United Kingdom Royal College of Ophthalmologists National Ophthalmology Database Cataract Audit.
Methods
Post-cataract surgery severe vision loss (SVL) was defined as a loss of ≥0.60 LogMAR between preoperative presenting visual acuity and postoperative visual acuity. The term ‘legally blind’ was used for eyes with a corrected visual acuity of worse than 1.30 LogMAR.
Results
Severe vision loss was recorded in 3723 (0.21%) eyes, including 3 eyes (2 patients) from 2718 immediate sequential bilateral cataract surgery (ISBCS) eyes.
The highest observed SVL rate was 10.68% for eyes left aphakic after surgery, and the second highest SVL rate (3.32%) was when posterior capsular rupture occurred. The SVL rate was higher than the overall rate for eyes with previous intravitreal injections (0.76%), eyes with optic nerve or central nervous system problems (0.74%), age-related macular degeneration (0.52%), previous vitrectomy (0.49%), diabetic retinopathy (0.45%), glaucoma (0.42%), or corneal pathology (0.33%).
Of 1642386 eyes who were not preoperatively legally blind, 2731 (0.2%) were postoperatively legally blind.
Conclusions
Whie estimates exist for the risk of specific complications, such as post-operative infectious endophthalmitis, the 'catch-all' risk for severe vision loss is less well documented.
Severe vision loss from any cause following cataract surgery occurs infrequently. However, it has a higher prevalence in eyes left aphakic, when PCR occurs and for certain ocular comorbidities.