Abstract
Purpose The number of very elderly patients waiting for cataract surgery is predicted to increase. The aim of our study was to determine the clinical outcome following cataract surgery in this age group.
Methods In this retrospective study, patients aged 96 years and above, who underwent cataract surgery between June 1993 and January 2001, were identified. Clinical data were retrieved from their medical records. Living patients were further invited for clinical examination.
Results In all, 34 eyes of 21 patients (20 females) were identified. Six patients were deceased. In total, 30/34 eyes had phacoemulsification and four had extracapsular extraction. Preoperative vision was ≤6/36 in 24/34 eyes (70.59%) and ≤CF in 16/34 eyes (47.06%). Postoperative vision was ≥6/60 in 25/34 eyes (73.53%), ≥6/18 in 21/34 eyes (61.76%), and ≥6/9 in 10/34 eyes (29.41%). Visual acuity improved in 24/34 eyes (70.59%) and remained the same in 6/34 eyes. Complications included anterior capsule tear (three), zonular dialysis with vitreous loss (one), posterior capsule rupture with vitreous loss (one), incarceration of iris to paracentesis wound (two), postoperative uveitis (two), and posterior capsular opacification (19). In all, 7/34 eyes had undergone YAG capsulotomy.
Conclusion Surgeons should not be deterred from offering cataract surgery to the very elderly as successful visual rehabilitation is the norm. A further prospective multicentre study is required to confirm the benefits and assess the risks of cataract surgery in this age group.
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References
Bernth-Petersen P, Ehlers N . Cataract extraction in the nineties. Acta Ophthalmol 1983; 61: 392–396.
Wong TY . Cataract surgery in patients with cataract and age related macular degeneration: do the benefits outweigh the risks? Br J Ophthalmol 2000; 84: 1337–1341.
Sakabe I, Oshika T, Lim SJ, Apple DJ . Anterior shift of zonular insertion onto anterior surface of human crystalline lens with age. Ophthalmology 1998; 105: 295–299.
Lundstorm M, Stenevi U, Thorburn W . Cataract surgery in very elderly patients. J Cataract Refract Surg 2000; 26: 408–414.
Applegate WB, Miller ST, Elam JT, Freeman JM, Wood TO, Gettlefinger TC . Impact of cataract surgery with lens implantation on vision and physical function in elderly patients. JAMA 1987; 257: 1064–1066.
Westcott MC, Tuft SJ, Minassian DC . Effect of age on visual outcome following cataract extraction. Br J Ophthalmol 2000; 84: 1380–1382.
Elam JT, Graney MJ, Applegate WB, Miller ST, Freeman JM, Wood TO et al. Functional outcome one year following cataract surgery in elderly persons. J Gerontol 1988; 43: 122–126.
Goldcare MJ, Ingram RM . Changing workload in ophthalmology: some observations from routine statistics. BMJ 1983; 286: 1560–1563.
Hitchings RA . Visual disability and the elderly. BMJ 1989; 298: 1126–1127.
Elliott AJ . Poor vision and the elderly—A domiciliary study. Eye 1989; 3: 365–369.
Branch LG, Horowitz A, Carr C . The implications for everyday life of incident self—reported visual decline among people over age 65 living in community. Gerontologist 1989; 29: 359–365.
Stones MJ, Kozma A . Balance and age in the sighted and blind. Arch Phys Med Rehabil 1987; 68: 85–89.
Gerson LW, Jarjoura D, McCord G . Risk of imbalance in elderly people with impaired hearing or vision. Age Ageing 1989; 18: 31–34.
Tinetti ME, Williams TF, Mayewski R . Fall risk for elderly patients based on number of chronic disabilities. Am J Med 1986; 80: 429–434.
Pizzarello LD . The dimensions of the problem of eye disease among the elderly. Ophthalmology 1987; 94: 1191–1195.
Whitemore WG . Eye diseases in a geriatric nursing home population. Ophthalmology 1988; 96: 393–398.
Lim ASM, Khoo CY, Ang BC, Tan J, Heng LK . Eye diseases in the elderly in Singapore. Ann Acad Med 1987; 16: 46–53.
Gibson JM, Rosenthal AR, Lavery J . A study of the prevalence of the eye disease in the elderly in an English community. Trans Ophthalmol Soc UK 1985; 104: 196–203.
Jay JL, Devlin ML . The increasing frequency of surgery for cataract. Eye 1990; 4: 127–131.
Armbrecht AM, Findlay C, Kaushal S, Aspinall P, Hill AR, Dhillon B . Is cataract surgery justified in patients with age related macular degeneration? A visual function and quality assessment. Br J Ophthalmol 2000; 84: 1343–1348.
Cogbill TH, Strutt PJ, Landercasper J, Crosse L . Surgical procedures in centenarians. Wisconsin Med J 1992; 91: 527–529.
Desai P, Minassian DC, Reidy A . National cataract surgery survey 1997–98: a report of the results of the clinical outcomes. Br J Ophthalmol 1999; 83: 1336–1340.
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This material was presented as a poster at ARVO, Fort Lauderdale, May 2002 and the Royal College of Ophthalmologists meeting Manchester, May 2002
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Syam, P., Eleftheriadis, H., Casswell, A. et al. Clinical outcome following cataract surgery in very elderly patients. Eye 18, 59–62 (2004). https://doi.org/10.1038/sj.eye.6700521
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DOI: https://doi.org/10.1038/sj.eye.6700521
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