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Abstract
To determine prevalence, primary causes, and risk indicators of visual impairment
in cataract-operated eyes.
Population-based cross-sectional study of adult Latinos.
Two hundred sixty-one participants with cataract extraction.
Participants underwent an in-home interview and a comprehensive ophthalmologic examination.
Visual impairment in the cataract-operated eye was defined by presenting visual acuity
(PVA) of 20/40 or less or best-corrected visual acuity (BCVA) of 20/40 or less. The
association of cataract extraction status (aphakic, pseudophakic) and severity of
visual impairment was evaluated. Risk indicators associated with visual impairment
by BCVA in the worse-seeing cataract-operated eye were evaluated.
Visual acuity, causes of visual impairment, and risk indicators associated with visual
impairment.
Of the 261 participants with at least one cataract extraction and a complete clinical
examination, 100 (38%) participants had undergone a unilateral extraction and 161
(62%) had undergone bilateral extractions. The prevalence of visual impairment was
41% (n = 107) defined by BCVA and 60.5% (n = 158) defined by PVA in the worse-seeing
cataract-operated eye, and 32.2% (n = 136) defined by BCVA versus 48.1% (n = 203)
defined by PVA in all cataract-operated eyes. Uncorrected refractive error, age-related
macular degeneration, and diabetic retinopathy were the primary causes of visual impairment,
accounting for 49% in worse-seeing cataract-operated eyes and 57% in all cataract-operated
eyes. Self-reported history of glaucoma, barriers to eye care, and unmarried participants
were independent risk indicators associated with visual impairment (P<0.05).
Despite cataract surgery, a significant proportion of participants had residual visual
impairment. Refractive correction eliminated visual impairment in 15% to 20% of the
participants, demonstrating the need for regular ophthalmologic examinations in cataract-operated
patients.