Purpose: To evaluate and explain why some patients report more difficulties performing everyday activities 6 months after a cataract extraction than they did before surgery.
Setting: Cataract surgeons from 4 departments of ophthalmology affiliated with the National Swedish Cataract Outcome Register.
Methods: Patients were recruited from those having cataract extraction during March 1995, 1996, or 1997 at the participating units. Only patients who completed Catquest questionnaires before and after surgery and were evaluated to have a "no-benefit" outcome were included. The no-benefit outcomes were analyzed by using medical records and surgeon opinions. Possible and/or probable reasons for the outcome were identified.
Results: Several possible and/or probable reasons were identified as a single reason or combined with other reasons. The 5 most frequent reasons were ocular co-morbidity in the operative eye, anisometropia after surgery, problems with the nonoperative eye during follow-up, low disability score sum before surgery (no difficulties), and postoperative complications.
Conclusion: In about a third of the cases, the no-benefit outcome could probably have been avoided by better planning for both eyes; that is, both eyes should have surgery within a short time and waiting for second-eye surgery in cases with anisometropia should be avoided.