Reversal of glare disability after cataract surgery

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.