June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
The impact of glaucoma on functional visual improvement after cataract surgery: Results of the Veterans Affairs (VA) Ophthalmic Surgical Outcomes Data (OSOD) Project
Author Affiliations & Notes
  • David Sola-Del Valle
    VA Boston Healthcare System, Ophthalmology Department, Jamaica Plains, MA
    Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Abhishek R Payal
    VA Boston Healthcare System, Ophthalmology Department, Jamaica Plains, MA
    Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Luis A Gonzalez
    VA Boston Healthcare System, Ophthalmology Department, Jamaica Plains, MA
  • Tulay Cakiner-Egilmez
    VA Boston Healthcare System, Ophthalmology Department, Jamaica Plains, MA
  • Xi Chen
    VA Boston Healthcare System, Ophthalmology Department, Jamaica Plains, MA
    Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA
  • Amy Chomsky
    VA Tennesse Valley Healthcare System, Nashville, TN
    Vanderbilt Eye Institute, Vanderbilt University Medical School, Nashville, TN
  • Elizabeth F Baze
    Michael E. DeBakey VA Medical Center, Houston, TX
    Cullen Eye Institute, Baylor College of Medicine, Houston, TX
  • David Vollman
    St Louis VA Medical Center, St Louis, MO
    Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO
  • Mary Gilbert Lawrence
    DoD/VA Vision Center of Excellence, Bethesda, MD
  • Mary K Daly
    VA Boston Healthcare System, Ophthalmology Department, Jamaica Plains, MA
    Boston University School of Medicine, Department of Ophthalmology, Boston, MA
  • Footnotes
    Commercial Relationships David Sola-Del Valle, None; Abhishek Payal, None; Luis Gonzalez, None; Tulay Cakiner-Egilmez, None; Xi Chen, None; Amy Chomsky, None; Elizabeth Baze, None; David Vollman, ForSightV (C), Vistakon (C); Mary Lawrence, None; Mary Daly, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2110. doi:
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      David Sola-Del Valle, Abhishek R Payal, Luis A Gonzalez, Tulay Cakiner-Egilmez, Xi Chen, Amy Chomsky, Elizabeth F Baze, David Vollman, Mary Gilbert Lawrence, Mary K Daly; The impact of glaucoma on functional visual improvement after cataract surgery: Results of the Veterans Affairs (VA) Ophthalmic Surgical Outcomes Data (OSOD) Project. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2110.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To analyze functional visual improvement after cataract surgery in glaucomatous versus non-glaucomatous eyes.

Methods: The VA OSOD Project included 4,923 cataract surgery cases. In our retrospective analysis, we included eyes of patients who submitted both pre-operative and post-operative National Eye Institute-Visual Functioning Questionnaires (NEI-VFQ). We analyzed the NEI-VFQ composite scores using the Wilcoxon signed rank test as well as a linear mixed model that accounted for repeated measures and multiple variables. The difference in mean change in composite scores pre to post surgery was measured by analysis of variance.

Results: Of the 4,923 patients, 3,149 in the OSOD database completed both pre- and post-surgery NEI-VFQ questionnaires. Of those, 422 (13.4%) had glaucoma and 2,727 (86.6 %) did not. Pre-operative and post-operative questionnaires were submitted by 69.4% of glaucoma and 63.3% of non-glaucoma patients. Analysis of overall NEI-VFQ composite scores showed that cataract surgery led to a significant increase in visual function in glaucomatous (80.17 ± 19.13, p<0.0001) and non-glaucomatous eyes (84.71 ± 16.33, p<0.0001). Overall, eyes without glaucoma had significantly more improvement (p<0.0001). When stratified by pre-operative best-corrected visual acuity (BCVA), eyes without glaucoma had significantly better NEI-VFQ composite scores when the pre-operative BCVA was better than or equal to 20/40 (p<0.0001) or when the pre-operative BCVA was worse than 20/40 (p<0.0001).

Conclusions: Cataract surgery offers significant functional visual improvement for glaucomatous and non-glaucomatous eyes regardless of pre-operative BCVA, though the benefit appears greater for those without glaucoma.

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