title: The impact of cataract surgery on patients from a low-vision clinic.
abstract: OBJECTIVE
  To evaluate the effects of cataract extraction with intraocular lens implantation (CE-IOL) in low-vision patients.
  
  
  METHODS
  Prospective, interventional case series.
  
  
  METHODS
  Twenty low-vision patients (30 eyes) underwent CE-IOL by 1 surgeon at an academic institution.
  
  
  METHODS
  Pre- and post-CE-IOL visual acuities and responses to a 23-page survey (self-reported functioning in general vision, mobility, illumination, and ability to see faces) were compared.
  
  
  RESULTS
  Sixteen patients had age-related macular degeneration (AMD); 1 patient each had rod-cone dystrophy, oculocutaneous albinism, retinitis pigmentosa, or cerebrovascular accident. The average age was 78 years (range: 53-96 years). Preoperative best-corrected visual acuity (BCVA) ranged from 20/70 to count fingers; postoperative BCVA at 8 weeks was 20/40 to 20/400, with improvement in 25 (83%) eyes of 15 patients, and no change in the rest. The average change in logMAR of BCVA in the 1 eye or in the eye with better preoperative vision in bilateral surgery was an improvement of 0.6 logMAR units (p = 0.0001). Seventeen (85%) patients noted an improvement in visual function and would consent to CE-IOL again. Twelve patients completed the survey pre- and post-CE-IOL at 3 months. More patients could read with a magnifier after surgery. On average, self-reported functioning was improved.
  
  
  CONCLUSIONS
  In this small study, CE-IOL offered subjective and objective benefits to patients from a low vision clinic, many of whom may have been dissuaded from CE-IOL. Most patients had moderately dense cataracts and moderate to advanced AMD, and these features may help form clinical recommendations. Expectations are important to elicit preoperatively. Postoperatively, patients may be more receptive to low-vision services and devices when the prognosis for visual rehabilitation is better.
authors: Wilmer Eye Institute and Department of Ophthalmology, Baltimore, MD 21236, USA. ickuo@jhmi.edu
authors: Irene C
authors: IC
authors: Kuo
authors: Aimee T
authors: AT
authors: Broman
authors: Robert W
authors: RW
authors: Massof
authors: William
authors: W
authors: Park
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D015354:Vision, Low / Q000503:physiopathology / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology