A study of cataract extraction in people aged 75 and over in relation to near visual acuity, function, mental impairment and social adversity.

Drever, Fiona (1999). A study of cataract extraction in people aged 75 and over in relation to near visual acuity, function, mental impairment and social adversity. MPhil thesis The Open University.

DOI: https://doi.org/10.21954/ou.ro.0001022d

Abstract

The number of operations performed on the lens in Scotland continues to increase and specifically, cataract operations in the elderly aged 75 years and older have more than doubled over the last twenty years.

The aim of this project was to determine if certain factors could influence the decision to perform cataract extraction, specifically examining whether cataract surgery improves function in patients aged 75 years or older.

A quasi-experimental research design was used, namely a non-equivalent control group method. The experimental group (n=86) comprised consecutive patient admissions to the Eye Pavilion of the Royal Infirmary of Edinburgh, undergoing first eye cataract extraction under local anaesthetic, who were also 75 years or older and able to give informed consent The control group (n=46) was made up of macular degeneration patients from the records of both the Eye Pavilion of the Royal Infirmary of Edinburgh, and the Society for the Welfare and Teaching of the Blind. The control group subjects were also aged 75 years or older and were required to give informed consent. The experimental group subjects were assessed before surgery and again 6 months post operatively. Similarly, the control group were assessed initially and again 6 months later. The assessments for both groups were the same and comprised the Abbreviated Mental Test (AMT), Jebsen Hand Function Test (JHFT), Katz Index of Activities of Daily Living (ADL), Assessment of Living Skills and Resources (I ADL) and assessment of near vision acuity using the Keeler Reading Test Types.

The results of this study show that performance concerning IADL, JHFT and near visual acuity significantly improved in the experimental group following cataract extraction. Further analysis also indicates that near visual acuity and cognitive status are the best predictors of outcome in cataract patients aged 75 years or older. These results may have implications in the future for pre-surgical assessment of cataract patients, however further research is required to study the relationship between cognitive status and outcome.

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