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Showing papers on "Cataract surgery published in 1989"


Journal ArticleDOI
TL;DR: The use of smaller cataract incisions is thought to induce less astigmatism, resulting in a more stable refraction, and this results confirms an advantage of small incision surgery.
Abstract: The use of smaller cataract incisions is thought to induce less astigmatism, resulting in a more stable refraction. I analyzed the astigmatic changes in 99 cataract/intraocular lens patients with 4.0 mm incisions. Preoperative keratometry measurements were compared with those obtained one week, one month, and three months postoperatively. These changes, analyzed by vector analysis, revealed 0.13 D of induced with-the-rule astigmatism at one week, degrading to 0.22 D of against-the-rule at three months. This compares favorably with previously reported results of 6.0 mm and 10.0 mm incisions. This low amount of induced cylinder and rapid stabilization of the wound confirms an advantage of small incision surgery.

204 citations


Journal ArticleDOI
TL;DR: The authors' results and current literature suggest that absolute control, preoperatively and postoperatively, of all Uveitis inflammation and careful selection of patients as lens implant candidates are crucial for successful cataract surgery in uveitis patients.

192 citations


Journal ArticleDOI
TL;DR: Investigation of the role of exposure to ultraviolet light in the B range (UV-B) and other potential risk factors for the development of PSC cataracts suggested that UV-B exposure may be an important risk factor for PSCCataracts.
Abstract: • Posterior subcapsular (PSC) cataracts are a visually disabling form of cataract and account for 40% of surgical cases. Although PSC opacities may occur following intraocular inflammation, trauma, or use of steroids, the cause is often unknown. A case-control study was undertaken to investigate the role of exposure to ultraviolet light in the B range (UV-B) and other potential risk factors for the development of PSC cataracts. Surgical PSC cataract cases from a large rural ophthalmic practice on the lower eastern shore of Maryland were matched with phakic controls without PSC cataract changes from the same geographic area by age, sex, and referral pattern. All patients with PSC opacities who underwent cataract surgery in a 12-month period were chosen. One hundred sixty-eight cases and 168 controls were interviewed regarding sunlight exposure, drug use, occupational history, history of diabetes, hypertension, and other diseases. Matched-pairs analyses indicated that a history of relatively high exposure to UV-B was associated with increased risk of PSC cataracts. The association of PSC cataracts with steroid use and diabetes was reconfirmed. Subjects with blue eyes and less than high school education were also at increased risk for PSC cataracts. Smoking and hypertension were not found to be PSC cataract risk factors. These data suggest that UV-B exposure may be an important risk factor for PSC cataracts.

178 citations


Journal ArticleDOI
TL;DR: Four patients underwent cataract extraction with posterior chamber lens implantation several years after radial keratotomy and found the Binkhorst and the Holladay intraocular lens calculation formulas to be more accurate than the SRK II for these patients.

164 citations


Journal ArticleDOI
TL;DR: An estimated 5500 people in The Gambia require cataract surgery, 4600 eyelid surgery for entropion, and 4600 people spectacles to correct a refractive error which causes a visual acuity of less than 6/18.
Abstract: A population based survey of blindness and eye disease has been conducted throughout the whole country of The Gambia, and 8174 people were examined The prevalence of blindness (best acuity less than 3/60) was 07% and low vision (6/24-3/60) 14% The causes of blindness were cataract (55%), non-trachomatous corneal opacity/phthisis (20%), and trachoma (17%) An estimated 5500 people in The Gambia require cataract surgery, 4600 eyelid surgery for entropion, and 4600 people spectacles to correct a refractive error which causes a visual acuity of less than 6/18 More than half the current burden of blindness in The Gambia is potentially remediable through the provision of cataract surgery and aphakic spectacles

135 citations


Journal ArticleDOI
TL;DR: It is concluded that the phacoemulsification procedure induced significantly less astigmatism and provided faster visual rehabilitation than the ECCE procedure, and the use of small diameter PMMA IOLs inserted through small incisions minimized surgically induced cylinder in a way comparable to theUse of foldable silicone implants, while maintaining good visual results with fewer postoperative complications.
Abstract: Astigmatic changes in three series of cataract surgical procedures were compared. Two series comprised eyes having phacoennilsification and implantation of a foldable silicone lens through a 3.0 mm to 4.0 mm incision or a 5.8 mm diameter polyinethylmethacrylate (PMMA) lens through a 6.0 min incision. The third series comprised eyes having a planned extracapsular cataract extraction (ECCE) procedure through a 10.0 min incision and implantation of a PIMA posterior chamber lens. Surgically induced cylinder changes were compared by examining preoperative and postoperative dioptric cylinder power changes without regard to axis changes and by using vector analysis to compute induced cylinder for cases with axis changes. Both phacoemulsification series had similar mean induced cylinder levels, which were significantly less than mean induced cylinder in the ECCE group at both three and six months after surgery. Over 70% of the eyes in the two small incision phacoemulsification groups achieved an uncorrected visual acuity of 20/40 or better at three months, whereas only 28% of the ECCE group achieved that acuity. We concluded that the phacoemulsification procedure induced significantly less astigmatism and provided faster visual rehabilitation than the ECCE procedure. Furthermore, the use of small diameter PMMA IOLs inserted through small incisions minimized surgically induced cylinder in a way comparable to the use of foldable silicone implants, while maintaining good visual results with fewer postoperative complications.

125 citations


Journal ArticleDOI
TL;DR: The efficacy of periocular anesthesia appears to be comparable to that of retrobulbar anesthesia, in a prospective, randomized, masked study of 79 consecutive cataract extractions with intraocular lens implantations.
Abstract: • Complications of retrobulbar anesthesia are rare but significant. Periocular anesthesia has been advocated as an alternative to retrobulbar injections. In a prospective, randomized, masked study of 79 consecutive cataract extractions with intraocular lens implantations, 40 patients received retrobulbar injections and 39 patients received periocular injections. In every instance, the volume of the injection was 5 mL. No significant difference in surgeon's assessment of akinesia and anesthesia was found. Supplemental anesthesia was required in eight (21%) of the patients who received retrobulbar injections and in 11 (28%) of the patients who received periocular injections. A significant increase in chemosis was found with periocular injections. There was one complication with retrobulbar anesthesia and none with periocular anesthesia. No significant difference in patient assessment of comfort was found. The efficacy of periocular anesthesia appears to be comparable to that of retrobulbar anesthesia.

124 citations


Journal ArticleDOI
TL;DR: Postoperative intraocular pressure (IOP) was measured in patients with open-angle glaucoma undergoing extracapsular cataract extraction with a posterior chamber lens implant and combined surgery reduces the frequency and magnitude of, but does not eliminate, this complication.

112 citations


Journal ArticleDOI
TL;DR: Regulators view cataract surgery as a growing threat to the health care budget and increasing attention is being given to the indications for surgery and ways to reduce what appears to be the inexorable growth in the number ofCataract operations.
Abstract: Congress and the Health Care Finance Administration have recently targeted cataract extraction procedures for particular scrutiny and cost containment. The reasons have been amply stated: cataract surgery now accounts for 12% of the entire Medicare budget and is presently the most frequently performed surgical procedure reimbursed by Medicare. 1 Given the apparent threefold or greater increase in the annual number of cataract operations in the past decade and the prediction by some that the number of intraocular lens (IOL) implantations will approach 2 million per year, 2 regulators view cataract surgery as a growing threat to the health care budget. The Health Care Finance Administration has tried, largely in vain, to contain costs by reducing reimbursement. Increasing attention is therefore being given to the indications for surgery and ways to reduce what appears to be the inexorable growth in the number of cataract operations. Continued collection and analysis of

103 citations


Journal ArticleDOI
TL;DR: Two well-designed studies support many ophthalmologists' impression that posterior capsulotomy is associated with a higher incidence of pseudophakic cystoid macular edema (CME).
Abstract: To the Editor. —I read with great interest Dr Jampol's editorial in the July 1988 issue of theArchives. 1 It is reassuring to know that we now have two well-designed studies 2,3 that support many ophthalmologists' impression that posterior capsulotomy is associated with a higher incidence of pseudophakic cystoid macular edema (CME). However, it is possible that these studies underestimate the real incidence of postoperative CME because both studies include only patients treated with corticosteroids for the entire duration of the investigation. Therefore, the results reflect not only the effect of a primary posterior capsulotomy on the development of CME but also the effects of concurrent use of corticosteroids and the influence of a posterior capsule on corticosteroid ocular penetration and distribution. Although no well-controlled study has been reported that demonstrates that corticosteroids have any effect on prevention or treatment of CME, 4 many ophthalmologists believe they have a

73 citations


Journal ArticleDOI
TL;DR: After surgical treatment of the 16 retinal detachments, a good postoperative visual acuity was achieved in most cases and laser parameters, such as energy, exposures, and burst mode, and the method of cataract surgery (extracapsular or phacoemulsification) did not correlate with the incidence of retinal detachment.
Abstract: A retrospective study of 1,000 cases that had Nd:YAG laser posterior capsulotomy after cataract surgery is presented. We analyzed the correlation of the patient's age, axial length of the eye, method of cataract surgery, and laser parameters (exposures, energy, and burst mode) with the incidence of retinal detachment (1.6% overall). The highest risk for retinal detachment (12.3%) was in patients with an axial eye length of 26.1 mm to 28.0 mm. The average age of patients with retinal detachments was 60.6 years, ten years younger than the collective average age. Laser parameters, such as energy, exposures, and burst mode, and the method of cataract surgery (extracapsular or phacoemulsification) did not correlate with the incidence of retinal detachment. After surgical treatment of the 16 retinal detachments, a good postoperative visual acuity (better than 20/40) was achieved in most cases.

Journal ArticleDOI
TL;DR: Graft survival in a previously reported cohort of patients recruited between 1967 and 1978 was reviewed and compared with that for a cohort recruited between 1979 and 1987, allowing analysis of improved graft survival due to changes in management.

Journal ArticleDOI
TL;DR: The reduced phacoemulsification incision size in combination with a scleral pocket closed with a continuous single knotted 10‐0 monofilament nylon suture under tonometric and keratometric control significantly dampens the changes in corneal astigmatism during the early and late postoperative periods.
Abstract: All current cataract incisions induce transient and permanent changes in corneal astigmatism Typically, a two-phase astigmatic response is observed; an initial with-the-rule change is followed by an eventual and permanent against-the-rule shift from preoperative astigmatism The earlier literature suggests that the magnitude of the net astigmatic swing approximates 60 diopters for large limbal wounds closed with interrupted sutures However, applying the tenets of keratorefractive surgery to the cataract incision and its closure allows the surgeon to limit postoperative iatrogenic astigmatic swings The reduced phacoemulsification incision size in combination with a scleral pocket closed with a continuous single knotted 10-0 monofilament nylon suture under tonometric and keratometric control significantly dampens the changes in corneal astigmatism during the early and late postoperative periods My published reports, as evaluated in the present study, reveal that the net astigmatic swing may be reduced to less than 15 diopters, thereby affording rapid and stable optical results

Journal ArticleDOI
TL;DR: The incidence of complications of cataract surgery with intraocular lens (IOL) implantation have decreased in recent years and complications may be categorized into operative and postoperative, both early and late onset.
Abstract: Due to continued improvement in lens design, lens manufacturing, and surgical technique, the incidence of complications of cataract surgery with intraocular lens (IOL) implantation have decreased in recent years. Complications may be categorized into operative and postoperative, both early and late onset. Operative complications include posterior capsule rupture with or without vitreous loss, loss of all or part of the lens nucleus, iris damage, and stripping of Descemet's membrane. Early postoperative complications include pupillary block, hyphema, elevation of the intraocular pressure associated with the use of viscoelastic substances, persistent uveitis with or without hypopyon, and endophthalmitis. Late postoperative complications include IOL malposition, secondary glaucoma, cystoid macular edema, retinal detachment, and pseudophakic bullous keratopathy.

Journal ArticleDOI
TL;DR: In this paper, the incidence of pupillary fibrin membrane formation, a relatively frequent complication of cataract surgery in Japan even for experienced surgeons, was noted in 2038 consecutive cases of senile catarach removal and primary posterior chamber intraocular lens (PC IOL) implantation.

Journal ArticleDOI
TL;DR: Ten cataract extractions were performed on eight patients for whom warfarin was not discontinued prior to surgery, and three were complicated by hyphaema.
Abstract: Ten cataract extractions were performed on eight patients for whom warfarin was not discontinued prior to surgery. Three were complicated by hyphaema. No retrobulbar haemorrhages occurred in the four cases given a local anaesthetic. Cataract surgery can be performed successfully without discontinuing warfarin.

Journal Article
TL;DR: There were fewer early postoperative intraocular pressure rises associated with the combined procedures than were associated with cataract surgery alone, but there was an otherwise relatively lower complication rate in the latter group.
Abstract: Seventy-eight eyes of 69 patients with coexisting cataract and glaucoma underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation by one surgeon. A combined guarded filtering procedure was performed in 22 of these cases, and a two-stage procedure filtering surgery followed by cataract extraction was performed in 22 more. Cataract surgery alone was performed in the remaining 34. Since different criteria were used for selecting one of these three surgical approaches, and since baseline values in the three groups were not comparable, the significance of the results is limited. Observations of possible clinical significance, however, include the following: there were fewer early postoperative intraocular pressure rises associated with the combined procedures than were associated with cataract surgery alone, but there was an otherwise relatively lower complication rate in the latter group. All three groups had similar final intraocular pressures, although eyes undergoing the two-stage procedure, having had higher baseline pressures than those in the other two groups, had a higher percentage pressure reduction.

Journal ArticleDOI
TL;DR: The types and locations of retinal tears associated with 268 pseudophakic retinal detachments were studied as a function of the time at which they occurred following cataract surgery, with equatorial tears being significantly more common in early onset detachments than in those occurring after two years.
Abstract: The types and locations of retinal tears associated with 268 pseudophakic retinal detachments were studied as a function of the time at which they occurred following cataract surgery. Retinal detachments occurring more than two years following cataract extraction were significantly more likely to have their most posterior retinal break located at the posterior margin of the vitreous base than at or behind the equator. This distribution of tears was not observed in detachments occurring within six months of cataract surgery, with equatorial tears being significantly more common in early onset detachments than in those occurring after two years. The anterior tears which cause most retinal detachments long after cataract extraction are due to persistent chronic traction upon the vitreous base rather than to acute posterior vitreous detachment. RETINA 9:181-186, 1989

Journal ArticleDOI
TL;DR: An educational program including practice surgery, graded responsibility, and experienced assistance may be responsible in part for dramatically reducing the rate of vitreous loss during surgery done by the beginning resident.

Journal ArticleDOI
TL;DR: The results suggest that the fibrinous reaction seen several days after posterior chamber lens implantation may be caused by the proliferation of lens epithelial cells.
Abstract: I examined the effect of lens epithelial cell removal using ultrasound and aspiration in intercapsular cataract extraction on the prevention of postoperative complications associated with lens epithelial cells in 110 eyes. Since there was no fibrinous reaction on the intraocular lens in the early postoperative period, I feel the method was effective in preventing this complication. The results suggest that the fibrinous reaction seen several days after posterior chamber lens implantation may be caused by the proliferation of lens epithelial cells.

Journal ArticleDOI
TL;DR: A methodology for evaluating biomaterials intended for implantation in the eye is presented and the results for two elastomeric silicone intraocular lens materials are reported.
Abstract: The current trend toward small incision cataract surgery has resulted in the use of elastomers as intraocular lens materials. Little has been published on appropriate methods of evaluating biomaterials intended for implantation in the eye. We present a methodology for such a study and report the results for two elastomeric silicone intraocular lens materials. The chemical, optical, and mechanical properties of the two materials were evaluated, as was their stability to hydrolytic and ultraviolet degradation. Qualitative correlations between these properties and clinical requirements are discussed. Both silicone materials possessed the necessary properties for use as small incision intraocular lenses.

Journal ArticleDOI
TL;DR: The results of this series of lens implantations in children differ from previously reported studies, and may be attributed to the selection of the patients and to the surgery technique.
Abstract: All children under 19 years of age who are candidates for cataract surgery must be approved by the FDA and have the pediatric protocol approved by the Investigational Review Committee. Twenty-three children who were approved by FDA received 29 Sinskey-style posterior chamber intraocular lenses. Twenty-four were primary and five were secondary posterior chamber implants. Two minor complications could be attributed to the intraocular lens. Five other complications such as an opacifying posterior capsule and one retinal detachment could have occurred in any cataract procedure. The results of this series of lens implantations in children differ from previously reported studies. This difference may be attributed to the selection of the patients (i.e., all over the age of 20 months) and to the surgery technique.

Journal ArticleDOI
TL;DR: There was an upper limit on the time interval between extracapsular cataract extraction with posterior chamber intraocular lens placement and neodymium (Nd):YAG laser posterior capsulotomy, and the prolonged period of risk for elderly patients may be related to an age-related decline in lenticular hyperplasia.
Abstract: This retrospective study reviews the time interval between extracapsular cataract extraction with posterior chamber intraocular lens placement and neodymium (Nd):YAG laser posterior capsulotomy relative to the age of the patient at the time of cataract surgery. Two hundred thirteen consecutive laser procedures involving eyes that had had extracapsular cataract extraction within 6 years were reviewed. We found that there was an upper limit on the time interval from extracapsular cataract extraction to Nd:YAG posterior capsulotomy for all patients eventually requiring a Nd:YAG capsulotomy. This time limit appeared to be directly proportional to the age of the patient at the time of his or her cataract surgery: the older the patient at the time of surgery, the longer the period the patient was at risk for requiring a capsulotomy. Beyond this time limit, the likelihood that an Nd:YAG capsulotomy would be required was less than 2.5%. The prolonged period of risk for elderly patients may be related to an age-related decline in lenticular hyperplasia.

Journal Article
TL;DR: It is unclear whether the reported success of reported success reflected the pharmacological effects due to inhibition of the AA cascade - and hence, reflects the role of some eicosanoids in surgical miosis or postoperative fluorescein leakage - or reflect the effects of these drugs on unexplored physiological or pharmacological mechanisms.
Abstract: At the present time, corticosteroids are still the most effective class of drugs for the treatment of ocular inflammation. However, since their prolonged use may result in severe ocular side effects, it would be therapeutically beneficial to develop nonsteroidal anti-inflammatory drugs that have similar or greater efficacy than steroids, but do not share their ocular side effects. Several currently available non-steroidal drugs have been used clinically as prophylactic or therapeutic agents for the following: 1. Prevention of pupillary constriction during intraocular surgery (cataract extraction). 2. Prevention of postoperative inflammation, i.e., incidence of anterior chamber cellular reaction and aqueous flare (breakdown of blood-aqueous barrier) and IOP rise following cataract surgery, intraocular lens implantation, and argon laser trabeculoplasty. 3. Prevention of contact lens induced corneal neovascularization. 4. Improvement of lens opacity (bendazac). 5. Prevention of cystoid macular edema following intraocular surgery. Treatment over long-term period may be effective; postoperative treatment is ineffective. 6. Prevention of conjunctival hyperemia. Some prophylactic ocular uses such as prevention of surgical miosis or postoperative fluorescein leakage have been reported to be successful. However, it is unclear whether the reported success reflected the pharmacological effects due to inhibition of the AA cascade - and hence, reflects the role of some eicosanoids in surgical miosis or postoperative fluorescein leakage - or reflect the effects of these drugs on unexplored physiological or pharmacological mechanisms. For example, pretreatment with flurbiprofen to prevent surgical miosis was based on the assumption that PGs are potent miotic agents in all mammals, including humans. It remains to be established however, whether the small reduction in the extent of pupillary miosis is due to prevention of PG synthesis by this drug or to the prevention of the synthesis of other AA products, such as prostacyclin and thromboxane or possibly to some entirely different mechanism. Prevention of post-surgical fluorescein leakage by prophylactic pre and/or post surgical treatment with a variety of nonsteroidal anti-inflammatory agents is also assumed to be due to inhibition of intraocular PG synthesis, although the possibility that it is due to prevention of the synthesis of prostacyclin or TxA2 has not been ruled out. Even more important, it has not been demonstrated that prevention of this post operative fluorescein leakage reflects the prevention or inhibition of true CME and associated loss of visual acuity.(ABSTRACT TRUNCATED AT 400 WORDS)

Journal ArticleDOI
TL;DR: A questionnaire was sent round to the 200 members of the Netherlands Intraocular Implant Club, in which it appeared that 62% of the eye surgeons stopped ACT, whereas only 33% stopped the use of aspirin.
Abstract: A questionnaire was sent round to the 200 members of the Netherlands Intraocular Implant Club (NIOIC), in which they were asked about the policy followed in 1988 with regard to anticoagulant therapy (ACT) and the use of aspirin before and after cataract surgery. Ninety-nine formulas were returned, of which ninety-two were suitable for analysis. It appeared that 62% of the eye surgeons stopped ACT, whereas only 33% stopped the use of aspirin. After stopping ACT nine, in some cases serious, systemic complications arose. The continuation of ACT led to 3 ocular complications. It would appear that continuation of ACT and the use of aspirin is to be recommended.


Journal ArticleDOI
TL;DR: It is concerned that the complications associated with vitreous loss and with AC-IOLs may be acting in concert to cause visually disabling results.
Abstract: Vitreous loss is a serious complication of cataract surgery. Following vitreous loss it is common practice to perform a primary implantation of an anterior chamber lens (AC-IOL). We retrospectively analysed 642 consecutive cases of cataract extraction performed between 1983 and 1986 with special attention to those patients in whom vitreous loss occurred and an AC-IOL was placed. There were 27 such cases, and 24 of these were available for follow-up. Eighteen (75%) had visual acuity of 20/40 or better. All six patients (25%) who had a visual acuity of less than 20/40 in the operated eye had a functional visual acuity of 20/200 or less. Complications that occurred in this group are discussed. We are concerned that the complications associated with vitreous loss and with AC-IOLs may be acting in concert to cause visually disabling results.

Journal ArticleDOI
TL;DR: The results suggest it is necessary to remove the lens epithelial cells and the anterior capsule after posterior chamber lens implantation in intercapsular cataract extraction.
Abstract: Endocapsular phacoemulsification or intercapsular cataract extraction with lens epithelial cell removal using an ultrasound technique was performed on 30 eyes. The anterior capsule was not removed after posterior chamber intraocular lens implantation. After a mean follow-up period of 16.4 +/- 2.8 months, anterior capsule opacification was observed in six eyes, posterior synechias in six eyes, and shrinkage of the anterior capsule below the pupillary area, which resulted from the large opening needed for the intercapsular extraction, in 11 eyes. Other postoperative complications caused by lens epithelial cells such as posterior capsule opacification, intraocular lens dislocation, and fibrinous reaction did not occur. These results suggest it is necessary to remove the lens epithelial cells and the anterior capsule after posterior chamber lens implantation in intercapsular cataract extraction.

Journal ArticleDOI
TL;DR: It is demonstrated that with a meticulous anterior vitrectomy, good visual results can be achieved, although the risk of retinal detachment is higher than in uncomplicated cases.
Abstract: Implantation of an intraocular lens following vitreous loss at cataract surgery is a controversial decision. To address this issue, we retrospectively identified all cases performed at the University of Minnesota in the last three years that had either a posterior or an anterior chamber lens placed following anterior vitrectomy. Twenty patients had a posterior chamber lens implant; 14 had follow-up longer than six months. All these patients achieved 20/40 or better visual acuity, although one patient had a retinal detachment. Of the six patients with an anterior chamber lens implant, four achieved 20/40 or better acuity and two achieved 20/50 acuity with follow-up of six months; one patient had a retinal detachment. This review demonstrates that with a meticulous anterior vitrectomy, good visual results can be achieved, although the risk of retinal detachment is higher than in uncomplicated cases.

Journal ArticleDOI
TL;DR: Presurgical Miller‐Nadler scores were markedly elevated and correlated well with symptomatic glare, whereas postoperative scores were indistinguishable from normals, suggesting that cataract‐induced symptomatic glared is discernible, remediable, and warrants surgical intervention, but requires best‐case surgery to assure glare reversal.
Abstract: Awareness of the limitations of Snellen vision testing and the favorable risk-to-benefit ratio for cataract surgery have changed the indications for cataract rehabilitation. Interest in functional vision analysis generated the present study, which was designed to identify cataract-specific disabling glare and its reversal with best-case cataract surgical techniques. Thirty eyes with symptomatic cataracts and no other ocular diseases were evaluated by Miller-Nadler glare testing prior to and six weeks after surgery. All surgical cases were uncomplicated and were free of macular disease. They had well-centered posterior chamber intraocular lenses, clean posterior capsules, and were returned to 20/20 Snellen acuity. Careful patient selection assured that presurgical glare disability was due to cataract formation. Presurgical Miller-Nadler scores were markedly elevated and correlated well with symptomatic glare, whereas postoperative scores were indistinguishable from normals, suggesting that cataract-induced symptomatic glare is discernible, remediable, and warrants surgical intervention, but requires best-case surgery to assure glare reversal.