Cataract extraction in the 'nineties'.

A total of 55 cataract extractions were performed on 53 patients aged 90 years or more in the period 1972 to 1982. Assessment of the outcome was based on data from hospital records and on questionnaires to the patient's ophthalmologist and general practitioner. Cataract surgery had improved visual acuity in 42 patients. Only 25 patients (47%) could, however, utilize the improved visual acuity, and obtain some practical benefit from the cataract extraction. Thus, the benefits of cataract surgery seem to be reduced in this age group. The reasons appear to be a high frequency of severe macula degeneration, some degree of senility hindering the adaptation to aphakic spectacles, and a somewhat higher frequency of per- and post-operative complications. This suggests that indications for cataract surgery in very old patients should be limited, at least if rehabilitation with aphakic spectacles is planned. An earlier surgical intervention would probably have been advantageous in the majority of these patients.