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Andrea P. Dreyfuss; Improvement in Quality of life following Monocular or bilateral cataract extraction with lens implantation in patients in Lima Peru. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6666.
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Age related cataracts are responsible for 42% of the world blindness, affecting over 18 million people.Studies examining the clinical effectiveness and improvement in quality of life resulting from cataract surgery performed in emerging nations have rarely been conducted. A prospective study to examine these outcomes in a socioeconomically diverse population was conducted in Lima, Peru between November 2009 and June 2010 where 1490 consecutive cataract surgeries performed by two providers in a single clinic were studied.
Data of over 1700 cataract surgeries was collected by the Institute de Ojos Sacro Cuore (ISC) over a 6 month timeframe. The data involved the visual acuity of the patient and the Quality of Life (QOL15) questionnaire. A paired t-test was conducted to study the change in visual acuity after the surgery with and without corrective lenses. Next, regression analysis was utilized to evaluate the effect of cataract surgery on quality of life improvement. Finally we correlated the improvement in quality of life both before and after surgery in each eye for patients who underwent cataract surgery in both eyes.
Data collected included visual acuity before and after as well as quality of life (QOL15) surveys before and after. The visual acuity was found to improve after each surgery (p<0.0001), and for patients with poor initial visual acuity the quality of life improved as well (p=0.05). Patients who underwent surgery in both eyes had an overall increase in quality of life (p=0.0307) regardless of initial visual acuity. In this group, the increase in quality of life produced by first surgery was 18 times greater than that from the second surgery.
This study provides the first major study assessing the quality of cataract surgery in a Latin American country. According to the data analysis, large scale campaigns of cataract surgery in developing countries are effective both in improving visual acuity and quality of life in individuals from broad socioeconomic stratas. Furthermore, the final result suggests that when resources are scarce, quality of life can be improved significantly by operating on a single eye even though both eyes have significant cataracts.
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