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