Dissatisfaction with cataract surgery in relation to visual results in a population-based study in Sweden

Purpose: To evaluate dissatisfied patients and those with subjectively wors e visual ability after cataract surgery and to analyze how these factors re late to poor visual acuity results (worse than 20/40). Setting: Department of Ophthalmology, Norrlands University Hospital, Umea S weden. Methods: A prospective, population-based study of cataract surgery outcome was conducted. All patients (459 surgeries) who had cataract surgery during a 1 year period were studied using seif-administered questionnaires and da ta from patient records. Outcome measures were (1) patient degree of satisf action with the result, (2) subjective visual ability after surgery of visu ally demanding tasks such as reading, television viewing, orientation in un familiar surroundings, and distance estimation far and near, and (3) visual acuity results, Results: After surgery, 37 of the 459 cases (8%) were dissatisfied. These p atients had a significantly lower age-corrected visual acuity in the operat ed eye than the satisfied patients (P < .0001). Ten percent said 1 or more visual ability was worse after their cataract surgery, logistic regression analysis revealed that the visual acuity in the better eye before surgery a nd age-related maculopathy were the most significant risk factors. Poor vis ual acuity after surgery in the operated eye was found in 22%, mostly as a result of concurrent age-related maculopathy, diabetes, or glaucoma. Four p ercent had no improvement in visual acuity in the operated eye. Conclusions: Dissatisfaction seemed to rely mostly on visual acuity in the operated eye. Low visual acuity in the better eye before surgery and age-re lated maculopathy were the most significant risk factors for subjectively w orse visual ability after surgery. The degree of satisfaction after catarac t surgery and changes in visual ability differed in important ways from vis ual acuity as a measure of visual function. (C) 1999 ASCRS and ESCRS.