PURPOSE: To demonstrate the outcome for patients after cataract extraction using the Catquest cataract questionnaire and discuss the models validity in assessing outcome. SETTING: Thirty-five Swedish departments of ophthalmology. METHODS: Patients having cataract extraction performed by surgeons from 35 Swedish departments of opthalmology participated in the study. The questionnaire was given to 2970 consecutive patients having surgery during March 1995 at the participating surgical units. The questionnaire was sent by mail to patients and completed on a voluntary basis. It focuses on visual disabilities in daily life, activity level, cataract symptoms, and degree of independence. The results form the questionnaire are interpreted using a benefit matrix that credits not only a decrease in visual disabilities and cataract symptoms but also an improvement in or maintenance of a preoperative activity level. RESULTS: Complete surgical outcome data and completed preoperative and postoperative questionnaires were available in 1933 cases (65.1%). Benefit from surgery according to the model was achieved by 90.9% of the patients. Patients having their second cataract extraction had the highest frequency of the greatest benefit form surgery. There was good agreement between the different levels of benefit from surgery according to the model and the patient's global rating of his or her vision or achieved visual acuity after surgery, respectively. Patients with missing data (did not return postoperative questionnaire or had missing surgical result variables) were older and had a higher frequency of other diseases and handicaps. CONCLUSION: The Catquest cataract questionnaire allowed the outcome of cataract surgery to be graded by different levels of benefit. There seemed to be good agreement between this model of assessment and the patient's global rating of his or her vision. Missing data may be a problem when a postal questionnaire is used.
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