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PubMed2005

[Cataract patients with pseudoexfoliation (PEX) syndrome among a population with high prevalence of PEX. Clinical findings and morphological and surgical characteristics].

BACKGROUND: Cataracts are the most frequent treatable cause of noninfectious blindness in Oman. Therefore, in 2002 a study was performed at our department of ophthalmology to evaluate cataract patients for pseudoexfoliation. METHODS: In a prospective comparative cohort study, 370 age-related cataract eyes out of an evaluable population of 498 cataracts were evaluated by biomicroscopy, confocal corneal analysis, and electron microscopy and followed up after 6 months. RESULTS: Of 370 age-related cataracts without glaucomas 171 had PEX. Preoperative manifestations were 89 subluxations, 15 vitreous prolapses, 6 ciliolenticular blocks, and 7 intravitreal dislocations. In 40 Omani cataract eyes without PEX the endothelial cell count was normal compared to the age-matched US norm and corneal thickness was less than Caucasians, but more than Afro-Americans. CONCLUSIONS: This study reports on a high incidence and frequent preoperative complications (68%) of the surgical cataract cases in an Arabic population. The development of serious complications and blindness is related to the duration of the disease and the lack of timely surgery.

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PubMedDate not supplied

Corneal thickness in eyes following pars plana lensectomy for congenital cataracts.

PURPOSE: To evaluate the corneal thickness following pars plana lensectomy for congenital cataracts. METHODS: The corneal thickness was measured in 24 eyes of 24 patients with congenital cataracts who had undergone pars plana lensectomy at a mean age of 24 +/- 32 (SD) months. The mean age at the time of our evaluation was 15 +/- 3 years. These measurements were compared with those in 15 eyes of an age-matched group of 15 normal volunteers. The central corneal thickness and endothelium were evaluated in both groups. RESULTS: The mean corneal thickness of the cataract-extracted eyes (592 +/- 47 micro m) was significantly greater than that of the controls (529 +/- 43 micro m; P < 0.001). There was no significant difference in the corneal endothelial cell count between cataract-extracted eyes (3420 +/- 715/mm(2)) and the controls (3182 +/- 358/mm(2); P = 0.49). However, there were significant differences in the frequency of hexagonally shaped endothelial cells (63% +/- 8.4%, cataract-extracted eyes; 70% +/- 7.7%, controls; P < 0.01), and in the coefficient of variation in the endothelial cell size (33 +/- 6.0, cataract-extracted eyes; 26 +/- 4.8, controls; P< 0.01). CONCLUSION: The central cornea of congenital cataract-extracted eyes was significantly thicker than that of controls.

Adolescent↗
PubMed2004

Visual field changes after cataract extraction: the AGIS experience.

PURPOSE: To test the hypothesis that cataract extraction in glaucomatous eyes improves overall sensitivity of visual function without affecting the size or depth of glaucomatous scotomas. DESIGN: Experimental study with no control group. METHODS: One hundred fifty-eight eyes (of 140 patients) from the Advanced Glaucoma Intervention Study with at least two reliable visual fields within a year both before and after cataract surgery were included. Average mean deviation (MD), pattern standard deviation (PSD), and corrected pattern standard deviation (CPSD) were compared before and after cataract extraction. To evaluate changes in scotoma size, the number of abnormal points (P < .05) on the pattern deviation plot was compared before and after surgery. We described an index ("scotoma depth index") to investigate changes of scotoma depth after surgery. RESULTS: Mean values for MD, PSD, and CPSD were -13.2, 6.4, and 5.9 dB before and -11.9, 6.8, and 6.2 dB after cataract surgery (P < or = .001 for all comparisons). Mean (+/- SD) number of abnormal points on pattern deviation plot was 26.7 +/- 9.4 and 27.5 +/- 9.0 before and after cataract surgery, respectively (P = .02). Scotoma depth index did not change after cataract extraction (-19.3 vs -19.2 dB, P = .90). CONCLUSIONS: Cataract extraction caused generalized improvement of the visual field, which was most marked in eyes with less advanced glaucomatous damage. Although the enlargement of scotomas was statistically significant, it was not clinically meaningful. No improvement of sensitivity was observed in the deepest part of the scotomas.

Aged↗
PubMed2005

Interocular axial length difference in eyes with pediatric cataracts.

PURPOSE: We sought to report interocular axial length difference (IALD) between the operated eye and fellow eye at the time of pediatric cataract surgery. METHODS: A retrospective analysis of 171 cataractous (operated) eyes (mean patient age at surgery, 56.9 months; range, 0.2-230.0) was undertaken. Descriptive statistics, analysis of covariance, and regression analysis were used in statistical analysis. RESULTS: The mean IALD was 0.05 +/- 1.15 mm. If absolute values were used, mean IALD was 0.76 +/- 0.86. Nearly half of the subjects (48.0%) showed an IALD of >/=0.5 mm. Forty-one patients (24.0%) had operated (cataractous) eyes that were >/=0.5 mm shorter than the fellow eye, and 41 patients (24.0%) had operated eyes that were >/=0.5 mm longer than the fellow eye. The mean IALD in unilateral and bilateral cases was 0.10 +/- 1.33 and -0.03 +/- 0.76, respectively (P = 0.4). If absolute values were used, it was 0.98 +/- 0.90 and 0.40 +/- 0.65 in unilateral and bilateral cases, respectively (P < 0.001). IALD was more predictable in unilateral than in bilateral cases (P < 0.001). In unilateral cases, age at surgery (P = 0.04) and AL of the operated eye (P < 0.001) correlated with IALD. IALD did not correlate with gender, ethnicity, or type of cataract in either unilateral or bilateral cases. CONCLUSIONS: An IALD of >/=0.5 mm occurred in 48.0% of patients with pediatric cataracts and occurred more often with unilateral cataractous patients than with bilateral cases. In patients with unilateral cataract, age at surgery and AL of the operated eye could help predict the IALD.

Cataract↗
PubMed2006

Ocular axial length changes in pseudophakic children after traumatic and congenital cataract surgery.

BACKGROUND: Pseudophakic children tend to develop a large myopic shift. This may be in part due to accelerated growth in axial length. The purpose of this study was to evaluate and compare the postoperative change in axial length (DeltaAL) in pseudophakic eyes, after extraction of traumatic or congenital cataract. METHODS: Included in this retrospective study were 20 children who had undergone surgery for traumatic, unilateral congenital, or bilateral congenital cataracts. All patients were under 10 years old at the time of operation. Axial length was measured perioperatively as well as 1 year or more postoperatively. The three groups were subdivided according to patients' ages (below or above 5 years). The DeltaAL in the operated eyes was compared with DeltaAL of the fellow nonoperated eyes. The difference in DeltaAL between operated and fellow nonoperated eyes was compared among the groups. RESULTS: DeltaAL was greater for operated eyes than for fellow nonoperated eyes (traumatic cataract: p=0.06; unilateral congenital cataract, p=0.055). Axial elongation was significantly greater in children under 5 years old at operation than in those older than 5 (p=0.025). The difference in rate of DeltaAL between operated and fellow nonoperated eyes, per 1 year of follow-up, was similar for traumatic and unilateral congenital cataract groups. CONCLUSIONS: This study demonstrated a tendency toward greater axial lengthening in pseudophakic eyes of children, when compared with their nonoperated eyes. No significant difference was found in the tendency for increased axial lengthening between eyes operated on for traumatic cataracts and those operated on for congenital cataracts.

Body Weights and Measures↗
PubMed2005

Rapid, objective detection of cataract-induced blur using a bull's eye photodetector.

PURPOSE: To determine whether optical aberrations caused by cataract can be detected and quantified objectively using a newly described focus detection system (FDS). SETTING: The Wilmer Opthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. METHODS: The FDS uses a bull's eye photodetector to measure the double-pass blur produced from a point source of light. To determine the range and level of focus, signals are measured with a series of trial lenses in the light path selected to span the point of best focus to generate focus curves. The best corrected visual acuity (BCVA), refractive error, lens photograph grades, and FDS signals were obtained in 18 patients scheduled to have cataract surgery. The tests were repeated 6 weeks after surgery. RESULTS: The mean FDS outcome measures improved after cataract surgery, with increased peak height (P=.001) and decreased peak width (P=.001). Improvement in signal strength (integral of signal within +/-1.5 diopters of the point of best focus) strongly correlated with improvement in peak height (R(2)=.88, P<.0001) and photographic cataract grade (R(2)=.72, P<.0001). The mean BCVA improved from 20/50 to 20/26 (P<.0001). The improvement in BCVA correlated more closely with FDS signal strength (R(2)=.44, P=.001) than with cataract grade (R(2)=.25, P=.06). CONCLUSIONS: Improvement in FDS outcome measures correlated with cataract severity and improvement in visual acuity. This objective approach may be useful in long-term studies of cataract progression.

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PubMed2005

Cataract surgery in eyes with iridoschisis using the Perfect Pupil iris extension system.

PURPOSE: To evaluate the use of the Perfect Pupil system (Milvella Pty. Ltd.) in 3 eyes in cataract surgery with iridoschisis. SETTING: Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. METHODS: Patient 1 was an 83-year-old man with a nuclear cataract, pseudoexfoliation syndrome, and iridoschisis. He was also having systemic anticoagulation therapy. Preoperative best corrected visual acuity (BCVA) was 0.05 in the right eye and 0.08 in the left eye. Patient 2 was a 73-year-old mentally retarded man with a brunescent cataract in the right eye. Preoperative BCVA was 0.1. RESULTS: In the first patient, cataract surgery was performed under topical anesthesia in both eyes through a clear corneal incision. Intraoperative pupil size was 3.0 mm. The Perfect Pupil device was inserted manually and fixated at the iris rim, leading to pupil dilation of 6.0 mm. Uneventful cataract surgery was performed without damage to the iris. Hydrophobic acrylic foldable intraocular lenses (IOLs) were implanted with forceps. Postoperative BCVA was 0.5 in the right eye and 0.4 in the left eye. The second patient was operated on under general anesthesia. Pupil dilation was successfully achieved. The brunescent cataract was removed and a hydrophobic acrylic IOL was implanted with an injector, resulting in postoperative uncorrected visual acuity of 0.3. CONCLUSION: In iridoschisis patients, there is risk of aspiration of iris fibers during cataract surgery. In these 2 patients, this was prevented using the Perfect Pupil system.

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PubMed1996

Excimer laser phototherapeutic keratectomy before cataract extraction and intraocular lens implantation.

PURPOSE: To determine whether sequential excimer laser phototherapeutic keratectomy (PTK) followed by cataract extraction and intraocular lens (IOL) implantation with power calculation based on the new corneal curvature is effective in managing superficial corneal disease. METHODS: Of a consecutive series of 18 eyes of 16 patients who received PTK, extracapsular cataract extraction, and posterior chamber IOL insertion, twelve eyes had spheroidal degeneration and six eyes, calcific band keratopathy. The PTK was done with either a Summit ExciMed laser or a Visx 20/20 laser using a 5.0 to 6.0 mm diameter ablation zone. Intraocular lens calculations were done a mean of 3.3 months after PTK. Cataract surgery was by extracapsular cataract extraction with posterior chamber IOL implantation. Patients were followed up for a mean of 14 months. RESULTS: Eighteen eyes completed follow-up examinations. Mean time between PTK and cataract surgery was 3.3 months. Phototherapeutic keratectomy was completed in one surgery session using one ablation treatment (ablation and slitlamp microscopy) in five eyes, two treatments in seven eyes, and three to seven treatments in six eyes. Eleven (61%) of 18 eyes had a final spherical equivalent refraction within +/- 1.00 diopter. Two eyes developed moderate to marked subepithelial reticular corneal haze from PTK. No vision-threatening complications occurred. CONCLUSION: Excimer laser PTK followed by cataract extraction and posterior chamber IOL implantation can safely and effectively treat eyes with superficial corneal disease and age-related cataract. Calculation of the IOL power after the cornea has healed from the PTK compensates for changes in corneal curvature.

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PubMed1994

Outcome of cataract operations performed to permit diagnosis, to determine eligibility for laser therapy, or to perform laser therapy of retinal disorders.

Cataract operations may be recommended when retinal disease is suspected but cannot be adequately diagnosed or treated because of lens opacity. We evaluated the outcome of cataract operations performed under those circumstances. We reviewed the records of 119 patients who were examined at the Wilmer Retinal Vascular Center and within three months underwent a cataract operation. We identified 17 patients (20 eyes) who underwent a cataract operation at the recommendation of a retinal specialist, to permit diagnosis, to determine eligibility for laser therapy, or to perform laser therapy. After the cataract operation, eight (40%) of the 20 eyes were found to have a retinal disease for which laser therapy was recommended, and six (30%) of the 20 eyes underwent laser therapy that, before the cataract operation, had been impossible. These results indicate that a cataract operation may be useful when lenticular opacity prevents diagnosis or treatment in a patient with a suspected retinal disorder.

Adult↗
PubMed1998

Prevalence of blindness and cataract surgery in Shunyi County, China.

PURPOSE: To estimate the prevalence of blindness and cataract surgery among older adults in rural China. METHODS: Cluster sampling was used in randomly selecting men and women aged 50 years or older for visual acuity testing and an eye examination in 28 villages in Shunyi County. The survey, which was carried out in the fall of 1996, was preceded by a pilot study in which operational methods were refined and quality assurance evaluations carried out. RESULTS: Of 5,555 enumerated subjects > or =50 years of age, 91.5% (5,084/5,555) were examined and 90.9% (5,052/5,555) were tested for visual acuity. In this population, 2.8% (139/5,052) were blind, defined as presenting visual acuity less than 6/60 in both eyes. Blindness was associated with older age and female sex. Cataract was the principal cause of blindness in at least one eye in 48.2% (67/139) of blind people. The ratio of those blind from cataract who were operated on to the those who could have been operated on, cataract surgical coverage, was estimated to be 47.8% (54/113). Cataract surgery was associated with younger age but not sex or education. CONCLUSIONS: Blindness, particularly blindness related to cataract, continues to be a significant problem among the elderly, especially women, in this population-based sample of rural Chinese. Despite an active eye-care program in Shunyi County, only half of those who might benefit from cataract surgery are receiving it.

Age Distribution↗
PubMed2000

Prospective intrapatient comparison of extracapsular cataract extraction and lens implantation with and without trabeculectomy.

PURPOSE: To determine whether extracapsular cataract extraction and posterior chamber lens implantation combined with trabeculectomy provides better long-term results than extracapsular cataract extraction and lens implantation alone in a group of patients with primary open-angle glaucoma and cataract. METHODS: In a prospective, randomized clinical trial, 35 patients with bilateral, symmetric, primary open-angle glaucoma and visually disabling cataracts were randomly selected to undergo surgery with trabeculectomy in one eye and without in the other. All procedures were performed by a single surgeon in a private practice setting with follow-up for more than 5 years in all cases. RESULTS: After an average of 87 months of follow-up, extracapsular cataract extraction and posterior chamber lens implantation reduced intraocular pressure by 4.4 +/- 3.3 mm Hg, reduced the number of medications by 1.28 +/- 0.86, increased diopter vector of astigmatism by 1.49, and was associated with visual field loss in six of 35 eyes. After an average of 80 months of follow-up, extracapsular cataract extraction and posterior chamber lens implantation with trabeculectomy reduced intraocular pressure by 8.2 +/- 4.6 mm Hg (P =.0001), reduced the number of medications by 1.76 +/- 0.82 (P=.0002), increased diopter vector of astigmatism by 1.14, and was associated with visual field loss in one eye (P =.05). Both groups had similar improvement in visual acuity and perioperative complications. CONCLUSIONS: Extracapsular cataract extraction and posterior chamber lens implantation with trabeculectomy was beneficial in the long-term control of intraocular pressure and in prevention of visual field loss. This procedure should be considered for patients in whom long-term pressure control at a lower level would be beneficial in preventing further optic nerve damage.

Adult↗
PubMed1979

Late results of congenital cataract surgery.

Generally speaking, it can be said, when considering all operated bilateral congenital cataracts, that a visual acuity of over 20/100 is found in approximately 50% of patients. In this study, 230 eyes were followed; of these 100 (43%) had an acuity of 20/60 or better and 130 (57%) had 20/100 or less. In conclusion the functional prognosis is better for incomplete cataracts than for total congenital cataracts. The main reason for this is the fact that total cataracts are often associated with cerebroretinal lesions or anomalies. The patient's age at operation and the surgical technique chosen are secondary factors. When considered from the standpoint of visual acuity, the results of congenital cataract surgery are discouraging, at least in the eyes with complete cataract. The visual prognosis could be better for total congenital cataracts if we operate on them at birth or immediately after birth.

Adult↗
PubMed1985

Cataract surgery following cobalt-60 plaque radiotherapy for posterior uveal malignant melanoma.

We reviewed the records of thirteen patients with posterior uveal malignant melanoma who had developed a mature radiation cataract following cobalt-60 plaque radiotherapy. Cataract extraction had been performed in seven of these patients as of the survey date of this investigation. We attempted to determine if cataract extraction increased the risk of metastatic melanoma, improved or worsened visual function, or resulted in any consistent intraoperative or postoperative complications that did not occur if the cataract was retained. Our analysis showed that removing the cataract did not appear to increase the risk of death from metastatic melanoma, but it also indicated that cataract extraction did not seem to improve the visual function of the irradiated eye. On the basis of our experience to date, we offer suggested guidelines for the management of patients who develop a mature cataract following cobalt-60 plaque radiotherapy of a posterior uveal malignant melanoma.

Aged↗
PubMed1991

Effect of cataract on automated perimetry.

Humphrey visual fields (30-2 program) were performed on 24 otherwise healthy patients before and after cataract extraction to examine the effect of cataract on automated visual fields. All patients met reliability index criteria and recovered visual acuity of 20/25 or better. The effect of learning associated with repeated testing was controlled with visual fields of the fellow eye. Although a greater absolute threshold recovery occurred in the central region of the visual field after cataract extraction, the percent of threshold recovery did not vary across the visual field except for the most peripheral testing points, which demonstrated less recovery. Thus, cataracts depress an automated visual field fairly uniformly. Clinical grading of cataracts by a single experienced clinician was generally a poor predictor of visual field loss. Only the presence of posterior subcapsular plaque in the visual axis and the preoperative visual acuity correlated significantly with postoperative central threshold recovery. Pattern standard deviation remained unchanged after cataract removal, confirming it as a useful way of estimating visual loss from cataracts.

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PubMed1994

Variation in cataract surgery practice and clinical outcomes.

PURPOSE: To examine associations between surgical technique, patient and surgeon characteristics, and clinical outcomes of cataract surgery. METHODS: Seventy-five ophthalmologists were recruited from three cities based on a sampling scheme stratified by surgeon-reported annual volume of cataract surgery. Seven hundred seventy-two patients undergoing first eye cataract surgery were enrolled, with complete preoperative, perioperative, and 4-month postoperative clinical data on 717 patients (93%). RESULTS: Sixty-five percent of surgery was performed by phacoemulsification and 35% by standard extracapsular (ECCE) techniques. Performance of ECCE was associated with the presence of ocular comorbidity and 21 or more years in practice of the surgeon. Performance of phacoemulsification was associated with annual volume of cataract surgery, wherein high-volume (201-399 patients annually) and very high-volume (> 400 patients annually) surgeons had 3.7 and 3.9 times the likelihood of performing phacoemulsification compared with moderate-volume (51-200 cases annually) surgeons. The rates of intraoperative, perioperative, and 4-month postoperative adverse events and the amount of improvement in visual acuity did not differ either by surgical technique or volume stratum. The reported occurrence of posterior capsular opacification within 4 months of surgery was increased in the presence of cortical opacification, one city, and patients operated on by either high- or very high-volume surgeons. CONCLUSIONS: In this cohort, no difference in clinical outcomes, as measured by change in visual acuity or occurrence of postoperative adverse events (except for posterior capsular opacification), can be attributed to performance of phacoemulsification versus ECCE or to the reported annual volume of cataract surgery of the surgeon. Self-reported high and very high annual volume of cataract surgery is associated independently with performance of phacoemulsification and surgeon's report of posterior capsular opacification at 4 months after cataract surgery.

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PubMed1995

Predictors of outcome in patients who underwent cataract surgery.

PURPOSE: To identify preoperative patient characteristics associated with a lack of improvement on one or more measures 4 months after cataract surgery. METHODS: The authors collected preoperative and 4-month postoperative information on 552 patients undergoing first-eye cataract surgery from the practices of 72 ophthalmologists in three cities. The principal outcomes assessed were (1) Snellen visual acuity, (2) a cataract-related symptom score (possible range: 0, 0 of 6 symptoms present or bothersome, to 18, all 6 symptoms very bothersome), and (3) a measure of functional impairment in patients with cataract--the VF-14 score (possible range: 0, inability to perform any of the applicable activities, to 100, no difficulty performing any of the applicable activities). Multiple logistic regression was used to assess the association between preoperative patient characteristics and failure to improve on one or more outcome measures. Multiple linear regression was used to estimate the adjusted rate of lack of improvement in one or more outcome measures for one group of patients compared with another. RESULTS: Although 91 patients (16.5%) failed to improve on one or more of the outcome measures assessed, only 2 (0.4%) failed to improve on all three measures. The 91 patients who did not improve on at least one measure were approximately one sixth as likely to be satisfied with their vision postoperatively as the 461 patients who improved on all three outcome measures. Preoperative age of 75 years of age or older, VF-14 score of 90 or higher, cataract symptom score of 3 or lower, and ocular comorbidity (glaucoma, diabetic retinopathy, or age-related macular degeneration) were associated independently with increased likelihood of not improving on one or more measure (odds ratio: 3.57, 2.10, 3.29, and 2.16, respectively). The mean adjusted rate of failure to improve on at least one of the outcome measures ranged from 20.5% to 26.5% for patients with these preoperative characteristics compared with 8.8% to 13.8% for those patients without them. The preoperative level of Snellen visual acuity was not associated with the likelihood of not improving on one or more of the outcomes assessed. CONCLUSIONS: The authors conclude that specific preoperative characteristics (age, comorbidity, cataract symptom score, and VF-14 score) are independent predictors of patient outcome after cataract surgery.

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PubMed1997

Neovascular glaucoma developing after uncomplicated cataract surgery for heavily irradiated eyes.

PURPOSE: The purpose of the study was to evaluate the effect of cataract surgery and postoperative panretinal photocoagulation (PRP) on the development of neovascular glaucoma (NVG) in heavily irradiated eyes. PATIENTS AND METHODS: The authors performed a retrospective study on the incidence of NVG in 90 eyes that had received megavoltage external beam irradiation at a retinal dose of 56 to 80 Gy and that had at least 48 months of follow-up. These eyes were categorized into different groups depending on whether cataract surgery or PRP was performed. Rates and proportions of NVG occurring in these groups were compared and analyzed with one-tailed Fisher's exact test. RESULTS: The incidence of NVG was significantly higher in patients who underwent cataract surgery without postoperative PRP (P < 0.01). Neovascular glaucoma did not develop in any patient who underwent cataract surgery and PRP. CONCLUSIONS: Cataract surgery may accelerate the development of NVG in heavily irradiated eyes. Photoablation of ischemic retina is recommended before cataract surgery or soon thereafter if cataract density precludes laser treatment.

Adult↗
PubMed1999

Visual acuity and quality of life in patients with cataract in Doumen County, China.

PURPOSE: To evaluate the effectiveness of cataract surgery in achieving sight restoration and vision-related quality-of-life (QOL) in patients from rural southern China. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 109 cataract operated persons (152 eyes) and 654 unoperated persons. METHODS: Cluster sampling was used in identifying a random sample of 5342 persons 50 years of age and older for visual acuity and eye examinations. Visual functioning (VF) and QOL questionnaires were administered to aphakic and pseudophakic individuals, unoperated persons with presenting visual acuity less than 0.10 in either eye, and a sample of those with normal vision. MAIN OUTCOME MEASURES: Distance visual acuity, VF, and QOL questionnaire scores. RESULTS: Among the cataract operated participants, 43 (39.4%) were bilaterally operated on, 32.1% had presenting visual acuity less than 0.10 in both eyes with 8.3% greater than or equal to 0.32 in both eyes. Of operated eyes, 52.6% presented with visual acuity less than 0.10, 23.7% greater than or equal to 0.32; with best correction, the corresponding percentages were 21.1% and 42.1%. Uncorrectable aphakia due to surgical complications was common. In a multivariate regression model, better visual acuity outcomes were associated with higher level surgeon practice settings and recent surgery. On a 0 to 100 scale, mean VF and QOL scores for the cataract operated population were 41.6 and 54.5, respectively. Mean scores ranged from 84.4 and 93.4, respectively, for the unoperated persons with normal vision, to 14.6 and 31.2, respectively, for those with visual acuity less than 0.05 in both eyes. The VF and QOL scores were closely correlated with presenting visual acuity in both cataract operated and unoperated populations (r = 0.49-0.64). Scores among the cataract operated population were not influenced by age, gender, or education level. Among the unoperated population, lack of education was associated with lower VF and QOL scores (P = 0.017 and P = 0.005, respectively), and older age was associated with lower QOL scores (P < 0.001). CONCLUSION: Patients in rural southern China are not realizing the full sight-restoring potential of modern-day cataract surgery. Remedial efforts are needed to improve the performance of local eye surgeons.

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