Open Journal of Ophthalmology, 2013, 3, 90-92
http://dx.doi.org/10.4236/ojoph.2013.33021 Published Online August 2013 (http://www.scirp.org/journal/ojoph)
Preoperative Management of Cataract Surgery
Candidates: An Evaluation of Their Perception and
Evgenia Kanonidou*, Vasileios Konidaris, Christina Kanonidou, Leonidas Papazisis
Department of Ophthalmology, General Hospital of Veria, Veria, Greece.
Received January 4th, 2013; revised February 5th, 2013; accepted March 4th, 2013
Copyright © 2013 Evgenia Kanonidou et al. This is an open access article distributed under the Creative Commons Attribution Li-
cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: To assess the primary visual disabilit y in patients with cataract and to ev aluate their preference regarding the
visual outcome after surgery. Materials and Methods: 120 patients (66 males, mean age 76.3 years, mean best cor-
rected visual acuity 5.2/10 binocularly) participated. Perception regarding the primary visual disability related to cata-
ract and preference of visual outcome after surgery were assessed by a questionnaire. All study procedures adhered to
the principles outlined in the Declaration of Helsinki for research involving human subjects, and all participants gave
written informed consent before their participation. Results: 74 patients (61.6%) had difficulty in distant vision, 5
(4.2%) in near vision, 17 (14.2%) mentioned blurred vision, 14 (11.7%) difficulty in driving especially at night, 7 (5.8%)
complained about monocular diplopia and 3 (2.5%) about anisometropia. All mentioned that they preferred to obtain
clear distant and near vision after cataract surgery. Conclusions: There was an interesting variety in visual disability
related to cataract. The difficulty in distant vision was the primary visual deficit in the majority of the patients and the
preference for clea r distant and near vision was the desired postoperative visual outcome.
Keywords: Cataract; Visual Outcome; Visual Disability; Quality of Life
1. Introduction ability in patients with cataract, their perception regard-
ing the postoperative visual outcome and their prefer-
ences regarding the preoperative management.
Cataract is one of the commonest causes of vision loss
and the commonest cause of reversible loss of useful
vision worldwide . It is defined as the loss of trans-
parency of the natural lens of the eye, usually due to the
ageing process [1,2]. The only treatment is surgery,
which has become the most frequent performed surgery
in industrialized countries . As the trend towards
smaller incisions and shorter operating time continues,
less sedation and anesthesia are required . Topical
anesthesia and intracameral anesthesia are the standard for
cooperative patients [4-6]. Snellen chart visual acuity is
the standard procedure to measure the preoperative visual
acuity and thereby the indication of cataract surgery and
the postoperative outcome. However, the disability of a
patient with cataract goes beyond the loss of visual acuity,
as decreased visual function is associated with poor qual-
ity of life and general functioning living activities. The
aim of this study was to evaluate the primary visual dis-
120 patients (66 males) with mean age 76.3 years old and
mean best corrected visual acuity 5.2/10 binocularly par-
ticipated in the study. All the patients were recruited
through the cataract clinic of the Department of Oph-
thalmology of General Hospital of Veria, Veria, Greece
for a time period of one year. All had a history of visu-
ally significant cataract for their daily activities for at
least six months and suffered from no other ocular co-
morbidity. All the participants were of a basic educa-
tional level and occupied themselves with agriculture.
Their perception regarding the primary visual disability
related to cataract, their preference with respect to the
visual outcome after cataract surgery as well as their at-
titudes related to the preoperative management was as-
sessed by means of a simple questionnaire. All study
*Corresponding a uthor.
Copyright © 2013 SciRes. OJOph
Preoperative Management of Cataract Surgery Candidates: An Evaluation of Their Perception and Preferences 91
procedures adhered to the princip les outlined in the Dec-
laration of Helsinki for research involving human sub-
jects, and all participants gave written informed consent
before their participatio n.
74 patients (61.6%) had difficulty in distant vision, 5
(4.2%) in near vision, 17 (14.2%) mentioned blurred vi-
sion as the primary visual disability associated with
cataract while 14 patients (11.7%) had difficulty driving
especially at night. Moreover, 7 patients (5.8%) com-
plained about monocular diplopia while 3 (2.5%) about
anisometropia (Figure 1). All the participants mentioned
that despite their preoperative refractive status preferred
to obtain clear vision for both distant and near after cata-
ract surgery. All the patients wanted the preoperative
general screening tests to be undertaken in the hospital
compared to private practice. 78 (65%) preferred to re-
turn home the day of the surgery while 42 (35%) would
felt more secure with a day residency in the hospital. 99
(82.5%) wanted the anesthesia to be provided by eye
drops instillation while 21 (17.5%) with injection. 78
(65%) preferred the surgery to be performed by a male
surgeon, 6 (5%) by female, while the rest (30%) did not
show any particular preference. 12 (10%) patients pre-
ferred to be transferred to the theatre with a patient bed,
40 (33%) with a wheel-chair, while the rest (57%) on
foot. The desired refractive outcome after cataract sur-
gery was clear vision for both distance and near in all
patients. All preferred to be examined every week after
the surgery and for a month’s period of time. All were
absolutely satisfied by their preoperative management
and the only reason for disappointment was the crowded
Our study provides important documentation about the
primary visual disability in patients with cataract and
their preference regarding the visual outcome after cata-
Figure 1. Primary visual disability in patients with cataract
who participated in our investigation.
ract surgery. It was interesting to observe the variety in
visual disability related to cataract, with difficulty in dis-
tant vision being the primary visual deficit in the major-
ity of the patients, as well as their preference for clear
vision for both distant and near as the desired postopera-
tive visual outcome. Recent studies suggest that poor
vision has a greater impact on patients’ lives than was
previously thought, comparable with major medical con-
ditions such as stroke . Moreover, the benefits of
cataract surgery on visual function have been demon-
strated in several investigations [8-10], suggesting that
cataract surgery improves functioning in everyday life
with respect to vision dependent activities.
Understanding the spectrum of disability associated
with visual impairment from cataracts can help clinicians
improve their approach to treat ment and rehabilitation o f
these patients. Additionally, in our study, it was interest-
ing to note that there was reluctance in the majority of
the patients for the surgery to be performed by a female
surgeon. This is pr obably related to elderly patients’ cau-
tiousness regarding female surgical skills in the rural area
of Greek territory.
In conclusion, in this article, perception of 120 patients
regarding the primary visual disability related to cataract
and preference of visual outcome after surgery were as-
sessed by a questionnaire to assess the primary visual
disability in patients with cataract and to evaluate their
preference regarding the visual outcome after surgery. As
patients have widely differing visual demands, it is vital
to take these into account when considering surgery in
order that surgery induced improvements in visual acuity
be translated by considerable gains in real life activities,
emotional and social life co mponents.
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