Visual outcomes for remote Australian Aboriginal people after cataract surgery

Purpose: To assess the visual outcomes and quality of life after cataract s urgery In Aboriginal people and compare them with a case-matched population of non-Aboriginal people living In remote and rural areas In the Top End o f the Northern Territory Methods: Patients living in remote areas of the Top End of the Northern Ter ritory who underwent cataract surgery between 1994 and 1999 were identified from records at the three major hospitals in the region. Eighty-three pati ents were Included In the study. Each patient underwent a complete ocular a ssessment and then was administered a standardized, field-tested, 12-item q uestionnaire concerning visual function. This was analyzed and the results of the Aboriginal and matched non-Aboriginal populations compared. Results: Sixty-one Aboriginal and 22 non-Aboriginal people from a total of 295 patients who underwent cataract surgery were included In the study. The two study groups were closely matched by sex, age at the time of surgery. time of follow up from surgery and the number who had undergone bilateral s urgery. The median preoperative visual acuity for the Aboriginal group was 6/60 against 6/24 of the non-Aboriginal group. After surgery, at the time o f follow up. 26% of eyes In Aboriginal patients did not correct to 6/12 or better with pinhole approximation. Posterior capsule opacities were the mos t common principal postoperative cause for a deterioration of visual acuity in both groups. Postoperative trauma was a common cause for a low best-cor rected visual acuity in the Aboriginal group but not in the non-Aboriginal group. The majority (75.5%) of Aboriginal patients were satisfied with thei r operated eyes. Patients who were dissatisfied all had a visual acuity wor se than 6/36. Aboriginal patients reported worse visual function than did t hose in the non-Aboriginal group. Conclusions: Cataract surgery has a beneficial effect on the visual acuity and quality or life of Aboriginal and non-Aboriginal people. As compared to their non-Aboriginal counterparts, most Aboriginal people underwent surger y when they were legally blind. had a lower level of attained postoperative visual acuity and a high incidence of uncorrected refractive errors and po sterior capsular opacification requiring laser capsulotomy. The positive im part of cataract surgery an the lives of the majority of Aboriginal patents is highlighted. as is the need for continued postoperative follow up.