Send to

Choose Destination
Br J Ophthalmol. 2018 Oct;102(10):1419-1424. doi: 10.1136/bjophthalmol-2017-311257. Epub 2018 Jan 4.

Population-based assessment of visual acuity outcomes following cataract surgery in Australia: the National Eye Health Survey.

Author information

Centre for Eye Research Australia Ltd, Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, Australia.
Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.
Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore.



To assess the visual outcomes of cataract surgery among a national sample of non-Indigenous and Indigenous Australians.


This was a population-based study of 3098 non-Indigenous Australians (50-98 years) and 1738 Indigenous Australians (40-92 years), stratified by remoteness. A poor postoperative outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity (PVA) <6/12-6/60, and a very poor outcome was defined as PVA <6/60. Effective cataract surgery coverage (eCSC; operated cataract and a good outcome (PVA ≥6/12) as a proportion of operable plus operated cataract) was calculated.


The sampling weight adjusted cataract surgery prevalence was 19.8% (95% CI 17.9 to 22.0) in non-Indigenous Australians and 8.2% (95% CI 6.0 to 9.6) in Indigenous Australians. Among the non-Indigenous population, poor and very poor PVA outcomes were present in 18.1% and 1.9% of eyes, respectively. For Indigenous Australians, these values were 27.8% and 6.3%, respectively. The main causes of poor vision were refractive error (non-Indigenous=41.8%; Indigenous=41.9%) and coincident disease (non-Indigenous=43.3%; Indigenous=40.3%). The eCSC rates in the non-Indigenous and Indigenous populations were 88.5% (95% CI 85.2 to 91.2) and 51.6% (95% CI 42.4 to 60.7), respectively.


Approximately half of eyes with a poor visual outcome postcataract surgery could be readily avoided through the appropriate refractive correction. The finding of a lower eCSC rate among Indigenous Australians suggests that improvements in access and quality of cataract services may be warranted in order to reduce cataract-related vision loss in the Indigenous population.


epidemiology; public health

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center