Purpose

To report the longitudinal visual functional outcome after cataract surgery over 20 years.

Setting

Eye clinic, Norrlands University Hospital, Sweden.

Design

Prospective population-based cohort study.

Methods

One hundred fourteen patients (86% of survivors) who had cataract surgery during a 1-year period (1997 to 1998) answered the same Visual Function Index-14 questionnaire (VF-14) preoperatively, 2 to 4 months postoperatively, and at 5, 10, 15, and 20 years after surgery. Most patients (100 [88%] of 114; 75% of survivors) also had a routine ocular examination, including corrected distance visual acuity (CDVA).

Results

The mean age of the114 patients in the study was 60.6 years (range 36 to 80 years) at the time of surgery. Twenty years after surgery, the median CDVA in the operated eye had deteriorated from Snellen acuity 20/20 (logarithm of the minimum angle of resolution [logMAR] 0.0) postoperatively to 20/23 (logMAR 0.07) (P = .001). Patients aged 70 years or older at surgery had the largest loss of CDVA at 20 years compared with younger patients. At 20 years, 63 (55%) of the 114 patients had no deterioration in subjective visual function and most patients (82 [72%]) had 10 points decline or less. Patients who were older at surgery had a more pronounced decline in VF-14 total score over 20 years (P = .002). Fifty-six (58%) of 96 patients had never been treated for posterior capsule opacification.

Conclusions

This prospective 20-year follow-up study provided estimates of longitudinal visual results. Cataract surgery also offered excellent long-term visual rehabilitation for the majority, especially younger patients, after 20 years, with a low requirement for Nd:YAG laser capsulotomy. The results in this study are of value for counseling younger patients with cataract and patients considering refractive lens surgery.

中文翻译：

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白内障手术的长期结果：一项基于人群的前瞻性研究的20年结果

目的

报告白内障手术20年后的纵向视觉功能结果。

设置

瑞典诺兰兹大学医院眼科诊所。

设计

基于人群的前瞻性队列研究。

方法

在1年期间（1997年至1998年）接受白内障手术的114位患者（占幸存者的86％）在术前，术后2至4个月以及5岁时回答了相同的视觉功能指数14调查问卷（VF-14）手术后10年，15年，15年和20年。大多数患者（114名患者中有100名[88％]；幸存者中的75％）也接受了常规的眼科检查，包括矫正远视力（CDVA）。

结果

该研究中114例患者的平均年龄为手术时的60.6岁（36至80岁）。手术后二十年，手术后眼睛的中值CDVA已从Snellen视力20/20（最小分辨角[logMAR] 0.0的对数）降至术后20/23（logMAR 0.07）（P  = 0.001）。与年轻患者相比，手术时年龄大于或等于70岁的患者在20岁时CDVA的损失最大。在20岁时，114例患者中有63例（55％）主观视觉功能没有恶化，大多数患者（82例[72％]）的症状下降了10分或更少。手术年龄较大的患者在20年内VF-14总得分的下降更为明显（P = .002）。96例患者中有56例（58％）从未接受过后囊混浊治疗。

结论

这项为期20年的前瞻性研究提供了纵向视觉结果的估计。白内障手术还为大多数人（尤其是年轻患者）在20年后提供了出色的长期视觉康复，并且对Nd：YAG激光囊切开术的要求较低。这项研究的结果对于咨询年轻的白内障患者和考虑进行屈光镜手术的患者具有重要的价值。