Aim: To describe the prevalence and visual outcomes of cataract surgery in an urban Asian population.
Methods: A population-based study of 3,280 (78.7% response rate) Singapore Malays aged 40-80 years. Participants had a standardized interview and comprehensive ocular examination. Poor postoperative visual outcome was defined as visual acuity ≤20/60 in operated eyes of unilateral, or better seeing eyes of bilateral surgical cases. Factors associated with poor visual outcome were assessed.
Results: Of 3,280 participants, 284 (men 52.3%) had unilateral cataract extractions (age-standardized prevalence 4.7%, 95% confidence intervals 4.2-5.4%) and 154 persons (54%) had bilateral extractions. Older age, men and the presence of diabetes were significant factors associated with having cataract surgery. Poor visual outcomes were present in 10.8 % of the operated eyes using best-corrected visual acuity. Diabetic retinopathy (25.5%), glaucoma (17%), age-related macular degeneration (14.9%) and posterior capsular opacification (14.9%) were the main causes of poor visual outcome after surgery. Under corrected refractive error accounted for 60% of cases with postoperative presenting visual acuity ≤20/60.
Conclusions: Five percent of the Malay population aged 40+ years in Singapore had cataract surgery. One in ten had postoperative best- corrected visual acuity of 20/60 or worse, largely related to concomitant retinal diseases.