Impaired visual function after cataract surgery assessed using the Catquest questionnaire

Purpose: To evaluate and explain why some patients report more difficulties performing everyday activities 6 months after a cataract extraction than t hey did before surgery. Setting: Cataract surgeons from 4 departments of ophthalmology affiliated w ith the National Swedish Cataract Outcome Register. Methods: Patients were recruited from those having cataract extraction duri ng March 1995, 1996, or 1997 at the participating units. Only patients who completed Catquest questionnaires before and after surgery and were evaluat ed to have a "no-benefit" outcome were included. The no-benefit outcomes we re analyzed by using medical records and surgeon opinions. Possible and/or probable reasons for the outcome were identified. Results: Several possible and/or probable reasons were identified as a sing le reason or combined with other reasons. The 5 most frequent reasons were ocular co-morbidity in the operative eye, anisometropia after surgery, prob lems with the nonoperative eye during follow-up, low disability score sum b efore surgery (no difficulties), and postoperative complications. Conclusion: In about a third of the cases, the no-benefit outcome could pro bably have been avoided by better planning for both eyes; that is, both eye s should have surgery within a short time and waiting for second-eye surger y in cases with anisometropia should be avoided. J Cataract Refract Surg 20 00; 26:101-108 (C) 2000 ASCRS and ESCRS.