Cataract surgery in the very elderly

Objective: To analyze the outcome of cataract extraction in patients aged 8 5 years and older (greater than or equal to 85 group) and to compare their outcome with that of patients younger than 85 years (less than or equal to 84 group). Setting: Cataract surgeons participating in the Swedish National Cataract O utcome Study during 1995 to 1997. Methods: A prospective observational study was performed that evaluated pat ients' self-assessed visual function before and 6 months after cataract ext raction. Mean age of the 4819 patients having cataract extraction at partic ipating clinics during March 1995, 1996, and 1997 with complete follow-up d ata was 75.6 years; 67.5% were women. Preoperative and intraoperative data were reported at the lime of surgery. Final postoperative visual acuity, re fraction, and keratometry were recorded. Each study period closed 6 months after surgery. The Catquest questionnaire was completed before surgery and 6 months after surgery. Results: Of those with complete data, 757 patients (15.7%) were in the grea ter than or equal to 85 group. In this group, visual acuity in the operativ e eye improved in 84.3% and a visual acuity of 0.5 or better was achieved i n 71.4%. A no-benefit outcome, as defined by the Catquest. questionnaire, w as found in 12.7% of the greater than or equal to 85 group and 8.4% of the less than or equal to 84 group. Conclusion: Elderly patients on average had a good outcome, although not as good as that in younger patients. Certain groups were identified as having an excellent result and others of having a high risk of an adverse outcome . J Cataract Refract Surg 2000; 26:408-414 (C) 2000 ASCRS and ESCRS.