Br J Ophthalmol 1999;83:62-65 ( January )
The need for cataract surgery: projections based on lens opacity,
visual acuity, and personal concern
Cathy A McCarty,
Jill E Keeffe,
Hugh R Taylor
Centre for Eye
Research Australia, University of Melbourne Department of
Ophthalmology, Royal Victorian Eye and Ear Hospital, Australia
Correspondence to: Dr Cathy McCarty, Centre for Eye Research Australia, University of
Melbourne Department of Ophthalmology, Royal Victorian Eye and Ear
Hospital, 32 Gisborne Street, East Melbourne, Vic 3002, Australia.
Accepted for publication 29 July 1998
AIM To assess the
projected needs for cataract surgery by lens opacity, visual acuity,
and patient concern.
METHODSData were
collected as part of the Melbourne Visual Impairment Project, a
population based study of age related eye disease in a representative
sample of Melbourne residents aged 40 and over. Participants were
recruited by a household census and invited to attend a local screening
centre. At the study sites, the following data were collected:
presenting and best corrected visual acuity, visual fields, intraocular
pressure, satisfaction with current vision, personal health history and
habits, and a standardised eye examination and photography of the lens
and fundus. Lens photographs were graded twice and adjudicated to
document lens opacities. Cataract was defined as nuclear greater than
or equal to standard 2, 4/16 or greater cortical opacity, or any
posterior subcapsular opacities.
RESULTS3271 (83%
response) people living in their own homes were examined. The
participants ranged in age from 40 to 98 years and 1511 (46.2%) were
men. Previous cataract surgery had been performed in 107 (3.4%) of the
participants. The overall prevalence of any type of cataract that had
not been surgically corrected was 18%. If the presence of cataract as
defined was considered the sole criterion for cataract surgery with no
reference to visual acuity, there would be 309 cataract operations per
1000 people aged 40 and over (96 eyes of people who were not satisfied
with their vision, 210 eyes of people who were satisfied with their
vision, and three previous cataract operations). At a visual acuity
criterion of less than 6/12 (the vision required to legally drive a
car), 48 cataract operations per 1000 would occur and people would be twice as likely to report dissatisfaction with their vision.
CONCLUSIONSEstimates
of the need for cataract surgery vary dramatically by level of lens
opacity, visual acuity, and patient concern. These data should be
useful for the planning of health services.
Keywords:
cataract surgery;
visual
acuity;
patient satisfaction
© 1999 by British Journal of Ophthalmology
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