Reading performance depending on the type of cataract and its predictability on the visual outcome Eva Stifter, MD, Stefan Sacu, MD, Herbert Weghaupt, MD, Franz Ko ¨nig, Sibylla Richter-Mu ¨ksch, MD, Arnulf Thaler, MD, Michaela Velikay-Parel, MD, Wolfgang Radner, MD Purpose: To investigate the influence of various types of cataract on reading per- formance in a standardized reading test setting. Setting: Department of Ophthalmology, University of Vienna, Vienna, Austria. Methods: The reading performance of 94 eyes with age-related cataract and nor- mal macular function was evaluated with the Radner Reading Charts preopera- tively and 4 weeks after cataract surgery. Distance visual acuity was tested with the ETDRS charts. Cataracts were graded using the Lens Opacities Classification System (LOCS) III, on which NO is nuclear opalescence and NC is nuclear color. Results: Patients with pure nuclear cataracts (LOCS III: NO/NC 2.1-5) achieved a normally high MRS (99.84%  7.65% of their postoperative MRS): preoperative MRS 1 : 190.6  30.74 words per minute (wpm); postoperative MRS 2 : 191.21  29.36 wpm. Patients with mixed nuclear-cortical cataracts (LOCS III: NO/NC 2.1-5; C2) preoperatively achieved 96.96%  5.6% of their postoperative MRS (MRS 1 : 175.77  31.54 wpm; MRS 2 : 181.34  30.56 wpm). In dense nuclear cata- racts (LOCS III: NO/NC5), the MRS was significantly reduced, achieving only 72.64  19.19% of the postoperative MRS (MRS 1 : 133.06  39.43 wpm; MRS 2 : 185.76  40.18 wpm). In posterior subcapsular cataracts, the preoperative MRS (134.1  33.72 wpm) was significantly lower than postoperatively (191.14  27.08 wpm). Conclusions: In contrast to dense nuclear cataracts and posterior subcapsular cataracts, the preoperative reading speed of patients with pure nuclear or nu- clear-cortical cataracts was normal at large print sizes. The preoperative evalua- tion of reading acuity and speed with standardized reading tests can therefore be used to estimate the postoperative reading performance in the latter 2 types of cataract. J Cataract Refract Surg 2004; 30:1259–1267  2004 ASCRS and ESCRS C ataract surgery has become one of the most com- to regain functional vision and, in particular, reading mon elective surgical procedures in ophthalmol- ability. 4,5 Because reading is inseparably linked to visual ogy. 1 The number of cataract patients is constantly function, losing the ability to read severely reduces the growing because of the steady increase in the popula- independence of the individual, and consequently the tion’s mean age in industrialized countries. 2,3 One of patients’ quality of life. 4,5 patients’ main motivations for undergoing surgery is In elderly patients, the incidence of ocular comor- bidity is high, particularly with respect to age-related macular degeneration (ARMD), which represents the Accepted for publication November 13, 2003. most common cause of poor visual outcome after cata- Reprint requests to Wolfgang Radner, MD, Prof, Department of Oph- ract surgery. 6–8 Patients with both ARMD and cataract thalmology and Optometry, University of Vienna, Waehringerguertel are often discouraged from cataract surgery because of 18-20, A-1090 Vienna, Austria. E-mail: wolfgang.radner@ univie.ac.at. the risk for unsatisfactory visual improvements and the  2004 ASCRS and ESCRS 0886-3350/04/$–see front matter Published by Elsevier Inc. doi:10.1016/j.jcrs.2003.11.051