First Author: K.Michalska-Małecka POLAND
Co Author(s): P. Gościniewicz D. Romaniuk W. Romaniuk
Purpose:
The aim of our study was to retrospectively evaluate the effect and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older.
Setting:
: Department of Ophthalmology, University Hospital No 5 of the Medical University of Silesia Katowice, Poland;
Head of Department: prof. dr hab. n. med. Wanda Romaniuk
Methods:
This study followed the tenets of the Declaration of Helsinki with informed consents being signed by all subjects.
The study was conducted between 2008 and 2010 in University Hospital No 5 of the Medical University of Silesia in Poland. In the study we involved a total of 122 patients (122 eyes) with senile cataract. The mean age of the patients was 91,22±2,28 years (between the ages of 90 and 100). The gender distribution was 79 females and 43 males. 113 of 122 eyes had phacoemulsification (Phaco) and 9 of 122 eyes had extracapsular extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were observed and analysed on the first day, three months, and six months after surgery. In analysed group there were patients with following disorders:
degeneration of the central retina - 44,26% (54 of 122),
glaucoma - 21,31% (26 of 122),
hypertension - 12,3% (15 of 122),
pseudoexfoliation syndrome (PEX) - 12,3% (15 of 122),
diabetes - 7,4% (9 of 122).
Results:
Mean postoperative scores were significantly better as compared to preoperative level. The best uncorrected preoperative visual acuity was ? 0,1 in 94 of 122 eyes (77,05%), between 0,2-0,4 in 24 of 122 eyes (19,67%) and between 0,5-0,7 in 4 of 122 eyes (3,28%). The best uncorrected postoperative visual acuity 3 months after surgery was ? 0,8 in 23 of 122 eyes (18,85%), between 0,5 and 0,7 in 28 of 122 eyes (22,95%) and between 0,2 and 0,4 in 33 of 122 eyes (27,05%).Visual acuity improved in 102 of 122 eyes (84%) and remained the same in 20 of 122 eyes (16,39%). In our investigations we have found also statistically significant implications of the cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma, what was not found in patients without glaucoma. The most important cause of visual impairment after cataract surgery in the studied group was AMD.
Conclusions:
Cataract is one of the most frequently occurring visual impairments among the ocular disease in the world. Cataract in very elderly patients can cause progressive painless vision loss. Because of the demographic shift in development countries toward older age, the prelevance over the whole population has increased. It is difficult to make cataract surgery to an elderly patient, owing to additional difficulties like a higher incidence of hard nucleus, smaller pupil sizes, high rate of exfoliation syndrome and difficult patient cooperation during surgery. The results of the study showed that when systemic conditions are stable both phacoemulsification and ECCE with IOL implantation for very aged patients are effective and safe. We concluded that advance in years isn’t contraindication for cataract removal. Restoration of visual function, especially in people with severe visual acuity reduction, has good impact on psychological status of patients. We concluded that advanced age isn’t a contraindication for cataract removal and we determined that cataract surgery with IOL implantation is effective procedure in aged patients.
Financial Disclosure:
None
