Postoperative visual outcome and factors related to poor visual acuity three months after cataract surgery were evaluated in 243 cataract patients operated on at the Oulu University Hospital in 1990. The surgical technique used was a planned extracapsular cataract extraction with implantation of an intraocular lens (IOL) in 240 cases: a posterior chamber IOL in 231 cases and an anterior chamber IOL in 9 cases. The postoperative visual acuity was 0.5 or better in 74.5% of the eyes, 11.9% (29 eyes) had low vision and 2.4% (6 eyes) were blind. The visual outcome was significantly related to age. The most common causes for low vision or blindness were age related macular degeneration and glaucoma. There was one case of postoperative endophthalmitis but other surgical complications did not result in visual loss. Visually significant posterior capsular opacification was observed in 2.5%, and significant postoperative astigmatism (> or = 3.5 D) was present in 11.1%.