Official ESCRS | European Society of Cataract & Refractive Surgeons


Are we performing cataract surgery too early? An analysis of patient-reported outcomes (PROs)

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Session Details

Session Title: Combined Cataract Surgery & Practice Styles

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 15:34

Venue: Free Paper Forum: Podium 2

First Author: : U.Harley UK

Co Author(s): :    E. Farquhar   A. Rotchford   K. Ramaesh                       

Abstract Details


Cataract surgery has been shown to improve not only visual acuity (VA) but also generic and vision-specific quality of life (QoL). The number of cataract operations being performed is increasing, with a growing trend towards earlier surgery. This study uses patient reported outcomes (PROs) to assess the benefit of performing early cataract surgery, in patients with VA of 6/9 or better.


Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK; Golden Jubilee National Hospital, Glasgow, UK; New Victoria Hospital, Glasgow, UK; Stobhill Hospital, Glasgow, UK


Fifty patients listed for cataract surgery with VA of 6/9 or better (<0.3 logMAR) were recruited. The cataract type and severity were graded using the Lens Opacity Classification System (LOCS iii). First and second generation PROs questionnaires, the Visual Function 14 (VF-14) and Impact of Visual Impairment (IVI), were used to measure visual function and vision specific quality of life (QoL). The questionnaires were undertaken pre-operatively and repeated four months post-operatively. Student’s independent t-test was used to compare VF-14 scores and the Mann-Whitney U test was used to compare IVI scores pre- and post-operatively.


The mean age of the sample analysed is 68.73 with a range of 36 - 89. 61% of the patients are female; 46% were 1st eyes; 43% were right eyes. Average pre-op VA was 0.13 logMAR (6/7.5). 13 patients had posterior subcapsular cataract, 31 had cortical cataract, and all had some degree of nuclear sclerosis. While data collection is ongoing, preliminary results including 41 patients show a statistically significant improvement in VF-14 score (mean difference ± SD 14.32 ± 13.47, t = -6.921, p< 0.001) and IVI score (median difference 6.5, IQR 9.75, p< 0.001) post-operatively.


Assessing patients’ perspectives by measuring patient reported outcomes (PROs) gives a more realistic indication of the benefit of cataract surgery, not just relying on visual acuity. Our study has shown a significant improvement in QoL after performing cataract surgery in patient with VA of 6/9 or better.

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