Cataract surgery in one eye or both. A billion dollar per year issue.

Worthen Center for Eye Care Research, Department of Ophthalmology, Georgetown University Medical Center, Washington, DC 20007, USA.

PURPOSE: To measure the relative effect of cataract surgery in the second eye compared with the first eye on functional impairment, satisfaction, and vision problems. METHODS: Seventy-five randomly selected ophthalmologists in three cities in the United States were enrolled in a National Study of Cataract Outcomes. They, in turn, referred eligible, sequential patients scheduled for first-eye cataract surgery. Interviews were conducted at enrollment, 4 months after first-eye surgery, and 12 months after first-eye surgery. An attempt was made to conduct a special, preoperative interview of those patients scheduled to undergo second-eye surgery before the 4-month interview. Each interview included administration of the VF-14 (a 14-item questionnaire that assessed visual function), as well as questions about symptoms possibly related to cataract, "trouble with vision," and satisfaction with vision. RESULTS: Seven hundred seventy-two patients were enrolled in the study, and interview data to 12 months were obtained from 669 (86%) patients. Of these patients, 243 (36%) underwent cataract extraction in the second eye during the 12-month period of observation. Overall, subjects who underwent cataract surgery in both eyes during the 12-month period had 61% greater improvement in VF-14 score (P < 0.001), 27% more decline in trouble with vision (P < 0.001), and 24% greater improvement in satisfaction with vision (P < 0.001) compared with those who underwent surgery in only one eye. CONCLUSIONS: Cataract surgery in the second eye of patients with bilateral cataract is associated with clinical and statistically significant improvement in functional impairment, trouble with vision, and satisfaction with vision.

PMID: 9098247 [PubMed - indexed for MEDLINE]