Comparison of the results of first and second cataract eye surgery

Objective: To compare the outcomes of second eye cataract surgery with thos e of first eye surgery. In particular, to evaluate changes in visual acuity (VA), visual function, and health status after the first and second eye su rgeries. Designs A cohort (case series) analysis of patients recruited in a clinical trial. Participants: A total of 403 consecutive patients with indication of noncom bined first eye or second eye cataract surgery were recruited in 3 public h ospitals in Barcelona, Spain, First eye surgery patients are compared to se cond eye surgery patients. Intervention: Patients were evaluated both before surgery and 4 months afte r surgery by a standardized telephone interview and clinical examination. Main Outcome Measures: Visual acuity, visual function index (VF-14), a 14-i tem instrument designed to measure visual function, and the Sickness Impact Profile (SIP), a generic measure of health status. Results: Full data were obtained from 315 (78%) patients: 249 who underwent first eye surgery only and 66 different patients who underwent second eye surgery. Significant improvement was found in both groups of patients for b est-corrected VA in the operated eye (4.4 Snellen lines, P < 0.001; 4.2 Sne llen lines, P < 0.001, respectively), VA in the better eye (2.8 Snellen lin es, P < 0.001; 1.4 Snellen lines, P < 0.001), and visual function (26.3 Sne llen lines, P < 0.001; 17.0 Snellen lines; P < 0.001). Four months after th e operation, the VF-14 of the second eye group was slightly better (93.4 vs . 88.5; P = 0.09; score range: 0, worst, to 100, best). Psyche-social SIP s cores improved in both groups (4.8, P < 0.001; 3.1, P = 0.016). Physical SI P score improved only in the first eye surgery group (1.8, P = 0.003) but n ot in the second eye surgery group (-1.0, P = 0.338; score range: 0, best, to 100, worst). Conclusions: The results of our study suggest that patients undergoing seco nd eye cataract surgery show significant improvements in VA, visual functio n, and psycho-social health status. However, global and physical health sta tus does not change after second eye cataract surgery.