Effect of age on visual outcome following cataract extraction

Aim-To determine the effect of age on final corrected visual acuity following cataract extraction. Methods-A case series of 880 patients aged 60 years and older undergoing cataract extraction between 1996 and 1999 was studied. The best corrected visual acuity was assessed at discharge from the service and the proportion of patients who achieved a postoperative acuity of greater than or equal to6/12 was determined for different age groups. Analysis was also performed after exclusion of patients identified preoperatively as having ocular comorbidity that was thought to limit their final corrected acuity. The odds ratios for visual outcome were calculated for age using multiple logistic regression analysis to adjust for other prognostic factors. Results-A significant age effect was observed, with the proportion of patients who had no ocular comorbidity identified preoperatively and who achieved a visual acuity of greater than or equal to6/12 at discharge decreasing with age (p<0.001). In patients with no comorbidity the odds of achieving an acuity of 6/12 were 4.6 times higher in the 60-69 year age group than in the oldest age group (80+ years). Conclusions-Age is a significant determinant of visual outcome. This has implications if a points system incorporating an assessment of visual acuity or if visual acuity alone is used to determine the threshold for eligibility for cataract surgery.