CATARACT-SURGERY IN ONE EYE OR BOTH - A BILLION-DOLLAR PER YEAR ISSUE

Purpose: To measure the relative effect of cataract surgery in the sec ond eye compared with the first eye on functional impairment, satisfac tion, and vision problems. Methods: Seventy-five randomly selected oph thalmologists 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. Intervi ews were conducted at enrollment, 4 months after first-eye surgery, an d 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 inclu ded administration of the VF-14 (a 14-item questionnaire that assessed visual function), as well as questions about symptoms possibly relate d 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%) patient s. Of these patients, 243 (36%) underwent cataract extraction in the s econd eye during the 12-month period of observation. Overall, subjects who underwent cataract surgery in both eyes during the 12-month perio d had 61% greater improvement in VF-14 score (P < 0.001), 27% more dec line in trouble with vision (P < 0.001), and 24% greater improvement i n satisfaction with vision (P < 0.001) compared with those who underwe nt surgery in only one eye. Conclusions: Cataract surgery in the secon d eye of patients with bilateral cataract is associated with clinicall y and statistically significant improvement in functional impairment, trouble with vision, and satisfaction with vision.