The Necessity for Second-eye Cataract Surgery in Bilateral Highly Myopic Patients with Good Visual Acuity in the Unoperated Fellow Eye

Abstract

Purpose: To evaluate the necessity for second-eye cataract surgery in bilateral highly myopic patients with good visual acuity in the unoperated fellow eye.

Materials and methods: Seventy-five bilateral highly myopic patients who underwent uneventful sequential cataract surgery (the eye with worse visual acuity operated first) were included in this prospective study. The preoperative BCVA of the eye with better visual acuity in these patients was ≤ 0.3 (logMAR, or Snellen ≥ 20/40). Binocular single vision examinations were performed 1 month after the first-eye and second-eye surgery, respectively. The VF-14 questionnaire was completed before first-eye surgery, 1 month after the first-eye and 1 month after the second-eye surgery, respectively.

Results: The first eye's postoperative SE was -3.07 ± 1.10D and the second eye's preoperative SE was -12.91 ± 5.15D. Binocular single vision functional parameters improved significantly after the second-eye cataract surgery compared with that after the first-eye surgery (all P < .001). The binocular single vision function was negatively correlated with the SE difference between the two eyes after the first-eye surgery. No difference was found between the scores of VF-14 questionnaire preoperatively and after the first-eye surgery. VF-14 score only improved significantly after the second-eye surgery compared with that after the first-eye surgery (P < .001).

Conclusion: In bilateral highly myopic cataract patients, binocular single vision function could improve significantly after the second-eye cataract surgery compared with after the first-eye surgery. Bilateral highly myopic patients may undergo second-eye cataract surgery earlier, even if cataract in that eye is not severe enough to affect the visual acuity.

Keywords: Cataract surgery; VF-14; binocular single vision; high myopia; visional acuity.