April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Impact Of First Eye Versus Second Eye Cataract Surgery On Quality Of Life: Results From The Veterans Affairs Ophthalmic Surgical Outcomes Data Program
Author Affiliations & Notes
  • Nakul Shekhawat
    Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee
  • Mary Lawrence
    Department of Defense / VA Vision Center of Excellence, Hyattsville, Maryland
  • Elizabeth Baze
    Michael E. DeBakey VA Medical Center, Houston, Texas
    Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
  • Mary Daly
    VA Boston Healthcare System, Boston, Massachusetts
  • Michael Sulewski
    Philadelphia VA Medical Center, Philadelphia, Pennsylvania
  • Amy Chomsky
    Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee
    VA Tennessee Valley Healthcare System, Nashville, Tennessee
  • Footnotes
    Commercial Relationships  Nakul Shekhawat, None; Mary Lawrence, None; Elizabeth Baze, None; Mary Daly, None; Michael Sulewski, None; Amy Chomsky, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5692. doi:
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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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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To determine whether first eye & second eye cataract surgery result in significant improvement in vision-related quality of life (VR-QOL).

Methods: : 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.

Results: : 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).

Conclusions: : 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.

Keywords: quality of life • treatment outcomes of cataract surgery • cataract 
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