VISUAL OUTCOMES OF CATARACT-SURGERY IN THE UNITED-STATES, CANADA, DENMARK, AND SPAIN - REPORT FROM THE INTERNATIONAL CATARACT-SURGERY OUTCOMES STUDY

Objective: To compare visual outcomes obtained following cataract surg ery in 4 sites in North America and Europe where considerable differen ces in the organization of care and patterns of clinical practice have been previously described. Methods: Patients scheduled for first eye- cataract surgery and aged 50 years or older were enrolled consecutivel y in a prospective multicenter study that collected clinical and patie nt interview data preoperatively and postoperatively. From the United States, 772 patients were enrolled; from the Province of Manitoba (Can ada), 159; from Denmark, 291; and from the City of Barcelona (Spain), 200. Preoperative and 4-month postoperative visual acuity was obtained for 92% of the patients (n = 1291). Results: The mean 4-month postope rative visual acuity of eyes operated on varied significantly across t he 4 sites (P<.001) and had the following Snellen decimal fraction mea surements: 0.49 in Barcelona, 0.65 in Denmark, 0.66 in Manitoba, and 0 .74 in the United States. However, while crude visual acuity outcome f igures varied significantly, no significant difference was observed ac ross the 4 sites regarding the risk of poorer visual outcome after con trolling for differences in age, preoperative visual acuity, and gener al health status for patients with no ocular comorbidity. Older age, p oorer preoperative visual acuity, poorer preoperative general health s tatus, and coexisting ocular comorbidity were predictors of a poorer v isual outcome. Conclusion: A previously identified variation in treatm ent modalities across the 4 sites did not seem to affect patients' vis ual acuity outcomes.