Biological age is more important than chronological age

EDITOR—Wong's article on the effectiveness of cataract surgery in elderly people contains an emphasis on chronological age and final visual acuity as a measure of success.1 Wong does not mention the importance of biological age of individual patients and pays little attention to the potential improvement in daily functioning associated with cataract surgery. These are important factors when considering patients of any age for cataract surgery. But they are difficult to measure quantitatively and difficult to investigate; consequently they are not easily shoehorned into guidelines or health policy. A visual acuity of 6/12 or better is generally taken as a successful outcome in most studies in this area, and Wong applies this assumption …