Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden.
J Cataract Refract Surg. 2019 Dec;45(12):1732-1737. doi: 10.1016/j.jcrs.2019.07.026.
To report the longitudinal visual functional outcome after cataract surgery over 20 years.
Eye clinic, Norrlands University Hospital, Sweden.
Prospective population-based cohort study.
One hundred fourteen patients (86% of survivors) who had cataract surgery during a 1-year period (1997 to 1998) answered the same Visual Function Index-14 questionnaire (VF-14) preoperatively, 2 to 4 months postoperatively, and at 5, 10, 15, and 20 years after surgery. Most patients (100 [88%] of 114; 75% of survivors) also had a routine ocular examination, including corrected distance visual acuity (CDVA).
The mean age of the114 patients in the study was 60.6 years (range 36 to 80 years) at the time of surgery. Twenty years after surgery, the median CDVA in the operated eye had deteriorated from Snellen acuity 20/20 (logarithm of the minimum angle of resolution [logMAR] 0.0) postoperatively to 20/23 (logMAR 0.07) (P = .001). Patients aged 70 years or older at surgery had the largest loss of CDVA at 20 years compared with younger patients. At 20 years, 63 (55%) of the 114 patients had no deterioration in subjective visual function and most patients (82 [72%]) had 10 points decline or less. Patients who were older at surgery had a more pronounced decline in VF-14 total score over 20 years (P = .002). Fifty-six (58%) of 96 patients had never been treated for posterior capsule opacification.
This prospective 20-year follow-up study provided estimates of longitudinal visual results. Cataract surgery also offered excellent long-term visual rehabilitation for the majority, especially younger patients, after 20 years, with a low requirement for Nd:YAG laser capsulotomy. The results in this study are of value for counseling younger patients with cataract and patients considering refractive lens surgery.
报告白内障手术后 20 多年的纵向视觉功能结果。
瑞典诺尔兰大学医院眼科诊所。
前瞻性基于人群的队列研究。
在一年（1997 年至 1998 年）期间接受白内障手术的 114 名患者（86%的幸存者）回答了相同的视觉功能指数-14 问卷（VF-14），分别在术前、术后 2 至 4 个月以及术后 5、10、15 和 20 年。大多数患者（114 例中的 100 例[88%]；幸存者中的 75%）还进行了常规眼部检查，包括矫正距离视力（CDVA）。
研究中的 114 名患者的平均年龄为 60.6 岁（36 至 80 岁）。术后 20 年，手术眼的中位 CDVA 从术后的 20/20（对数最小分辨角[logMAR] 0.0）恶化至 20/23（logMAR 0.07）（P=.001）。与年轻患者相比，手术时年龄在 70 岁或以上的患者在 20 年后 CDVA 的损失最大。20 年后，114 名患者中有 63 名（55%）主观视觉功能无恶化，大多数患者（82 [72%]）下降 10 点或更少。手术时年龄较大的患者在 20 年内 VF-14 总分下降更为明显（P=.002）。96 例患者中有 56 例（58%）从未接受过后囊混浊治疗。
这项前瞻性 20 年随访研究提供了纵向视觉结果的估计。白内障手术后 20 年，大多数患者（尤其是年轻患者）的视觉康复效果极佳，仅需低剂量的 Nd:YAG 激光囊切开术。这项研究的结果对于咨询年轻白内障患者和考虑屈光性晶状体手术的患者具有重要价值。
