Functional visual outcomes of cataract surgery in patients with 20/20 or better preoperative visual acuity

PURPOSE: To measure the visual outcomes after cataract surgery in patients with 20/20 or better preoperative visual acuity. SETTING: University-based cataract referral practice. METHODS: In this retrospective case review, 2 groups of patients with a corrected distance visual acuity (CDVA) of 20/20 or better in both eyes before cataract surgery were identified. Patients in the first group had a cataract in 1 eye and an intraocular lens (IOL) in the other eye. Patients in the second group had cataracts in both eyes. Each patient completed a Visual Function 14 (VF-14) questionnaire before and after cataract surgery. Changes in VF-14 scores were analyzed. RESULTS: The VF-14 scores improved significantly after cataract surgery in both groups. Patients with cataract in 1 eye and an IOL in the other eye before surgery (n = 28) had a mean improvement of 12.2 in the VF-14 score (P = .029). Patients with cataract in both eyes (n = 31) had a mean improvement of 14.5 in the VF-14 score (P<.0001). CONCLUSIONS: The functional vision of patients with 20/20 or better preoperative CDVA improved significantly after cataract surgery. This finding shows that arbitrary CDVA thresholds of worse than 20/20 cannot always be used to determine who will benefit from cataract surgery.