title: Long-term outcomes of cataract surgery: 15-year results of a prospective study.
abstract: OBJECTIVE
  To describe the change over a 15-year period in corrected distance visual acuity (CDVA), subjective visual function, and neodymium:YAG (Nd:YAG) frequency after cataract surgery.
  
  
  METHODS
  Eye Clinic, Norrlands University Hospital, Umeå, Sweden.
  
  
  METHODS
  Prospective longitudinal population-based cohort study.
  
  
  METHODS
  Patients who had cataract surgery during a 1-year period, 15 years previously (1997 to 1998), were included. All patients answered the same Visual Function-14 (VF-14) questionnaire preoperatively, 4 months postoperatively, and 5, 10, and 15 years after surgery. Most patients (88%; 168/190; 74% of survivors) also had an ocular examination. The CDVA was measured with logMAR charts.
  
  
  RESULTS
  The study included 190 patients (83% of survivors). Fifteen years after surgery, the median CDVA in the operated eye had deteriorated from 20/20 postoperatively to 20/25 (P = .0001). Sixty percent of the patients had worsening of CDVA of less than 0.1 logMAR units compared with postoperatively. Fifty-four percent (103/190) had no deterioration in subjective visual function (VF-14), and 79% (150/190) had 10 points of decline or less. Previous Nd:YAG laser capsulotomy was more common in those younger than 65 years at surgery (49% versus 25%) (P = .002).
  
  
  CONCLUSIONS
  The study confirms the effectiveness of cataract extraction, offering good long-term visual rehabilitation for the majority of the patients. The most common comorbidity causing large functional loss 15 years after surgery was age-related macular degeneration. Fifteen years after surgery, one half of the patients younger than 65 years at surgery had not required a posterior Nd:YAG laser capsulotomy.
  
  
  BACKGROUND
  The author has no financial or proprietary interest in any method or material mentioned.
authors.affiliation: From the Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden. Electronic address: eva.monestam@vll.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Mönestam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D064727:Posterior Capsulotomy / Q000706:statistics & numerical data*; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology*