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Nakul Shekhawat, Mary Lawrence, Elizabeth Baze, Mary Daly, Michael Sulewski, Amy Chomsky; Impact Of First Eye Versus Second Eye Cataract Surgery On Quality Of Life: Results From The Veterans Affairs Ophthalmic Surgical Outcomes Data Program. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5692.
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To determine whether first eye & second eye cataract surgery result in significant improvement in vision-related quality of life (VR-QOL).
Retrospective analysis of the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) from the VA Ophthalmic Surgical Outcomes Database. The VFQ-25 was administered pre- & post-operatively to first eye (N=60) & second eye (N=19) cataract surgery patients to assess VR-QOL in terms of 11 function-specific subscales & a composite score. Second eye patients had already undergone first eye surgery & completed related questionnaires, but also completed post-operative questionnaires for the second operation. To account for patient response bias during single eye operations, a "staged bilateral" group (N=44) underwent first & second eye operations but only completed questionnaires before the first operation & after the second, with no questionnaires in-between.
First eye, second eye, & bilateral surgeries all resulted in statistically significant improvement in VR-QOL for 10 of 11 subscales & composite score (P < .0001). There was no statistically significant difference in VR-QOL improvement between first & second eye surgery for 10 subscales & composite score. Bilateral surgery resulted in significantly greater improvement in "general vision" & "near activities" subscales than either first or second eye surgery (P < .05). Bilateral surgery improved spatial navigation in dim lighting & alleviated specific role difficulty, such as inability to engage in tasks for extended time periods, more than first eye surgery (P < .05). Postoperatively, second eye & bilateral surgery patients reported less need to remain at home due to eyesight than first eye surgery patients (P < .05).
Data shows statistically significant incremental increase in most categories of VR-QOL from first to second eye surgery. First eye surgery does not improve VR-QOL significantly more than second eye surgery. Data from second eye & bilateral surgeries indicates that further cataract surgery can improve VR-QOL in ways that first eye surgery alone cannot. The study may be limited by sample size.
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