title: The changing pattern of cataract surgery indications: a 5-year study of 2 cataract surgery databases.
abstract: OBJECTIVE
  The aim of this study was to describe changes over time in the indications and outcomes of cataract surgery and to discuss optimal timing for the surgery.
  
  
  METHODS
  Database study.
  
  
  METHODS
  Patients who had undergone cataract extraction in the Netherlands, Sweden, or Malaysia from 2008 through 2012.
  
  
  METHODS
  We analyzed preoperative, surgical, and postoperative data from 2 databases: the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) and the Malaysian National Cataract Registry. The EUREQUO contains complete data from the national cataract registries in the Netherlands and Sweden.
  
  
  METHODS
  Preoperative and postoperative corrected distance visual acuity, preoperative ocular comorbidity in the surgery eye, and capsule complications during surgery.
  
  
  RESULTS
  There were substantial differences in indication for surgery between the 3 national data sets. The percentage of eyes with a preoperative best-corrected visual acuity of 20/200 or worse varied from 7.1% to 72%. In all 3 data sets, the visual thresholds for cataract surgery decreased over time by 6% to 28% of the baseline values. The frequency of capsule complications varied between the 3 data sets, from 1.1% to 3.7% in 2008 and from 0.6% to 2.7% in 2012. An increasing postoperative visual acuity was also seen for all 3 data sets. A high frequency of capsule complication was related significantly to poor preoperative visual acuity, and a high frequency of decreased visual acuity after surgery was related significantly to excellent preoperative visual acuity.
  
  
  CONCLUSIONS
  The 5-year trend in all 3 national data sets showed decreasing visual thresholds for surgery, decreasing surgical complication rates, and increasing visual outcomes regardless of the initial preoperative visual level. Cataract surgery on eyes with poor preoperative visual acuity was related to surgical complications, and cataract surgery on eyes with excellent preoperative visual acuity was related to adverse visual results.
authors.affiliation: Department of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden. Electronic address: mats.lundstrom@karlskrona.mail.telia.com.
authors.forename: Mats
authors.initials: M
authors.lastname: Lundström
authors.affiliation: National Cataract Registry, Clinical Research Centre, Ministry of Health, Kuala Lumpur, Malaysia.
authors.forename: Pik-Pin
authors.initials: PP
authors.lastname: Goh
authors.affiliation: Department of Ophthalmology, VUmc, Amsterdam, The Netherlands.
authors.forename: Ype
authors.initials: Y
authors.lastname: Henry
authors.affiliation: Department of Ophthalmology, Sarawak General Hospital, Ministry of Health, Malaysia.
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Salowi
authors.affiliation: Royal Victoria Eye and Ear and St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: Barry
authors.affiliation: Ophthalmology Department, Cork University Hospital, Cork, Ireland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Manning
authors.affiliation: Oxford Eye Hospital, Oxford, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Rosen
authors.affiliation: Department of Ophthalmology, Sahlgren's University Hospital, Mölndal, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Stenevi
mesh_terms: D000368:Aged; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000639:trends*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications; D012042:Registries; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology