Abstract
Purpose: :
To determine the prevalence of visual impairment (VI) following cataract surgery and the impact of cataract and cataract extraction on quality of life (QOL) in a population–based sample of adult Latinos.
Methods: :
The Los Angeles Latino Eye Study is a population–based cross–sectional study of 6357 adult Latinos from six census tracts in Los Angeles, CA. Participants underwent a comprehensive ophthalmologic examination, including measurement of best corrected visual acuity (BCVA), and completed the NEI Visual Function Questionnaire 25 (NEI VFQ–25) to evaluate vision–specific QOL. VI was defined as a BCVA of 20/40 or worse in the cataract–operated eye. VI was classified as: mild (20/40–20/63), moderate (20/80–20/160) and severe (≤20/200). Frequency distributions were used to calculate the prevalence of VI in cataract–operated participants. Chi–square tests evaluated the association of VI and cataract extraction. Analysis of covariance compared the association between QOL and (i) bilaterally pseudophakic (BPPHK) participants and (ii) those with pseudophakia in one eye and cataract in the fellow eye (PPHKC).
Results: :
265 individuals had a cataract extraction performed in at least one eye resulting in 21 aphakic and 241 pseudophakic participants. 41% of cataract–operated participants had VI. An additional 20% of cataract–operated participants had VI which could be corrected by refraction. Of them, 69 (26%) had mild, 32 (12%) had moderate and 57 (22%) had severe VI. Participants in the PPHKC group (n=42) had lower QOL scores compared to those in the BPPHK group (n=129). The average subscale scores between the BPPHK and PPHKC groups were 73.3 and 63.5 for driving difficulties, 71.9 and 62.6 for vision–related role function, 61.3 and 52.3 for vision–related mental health, 71.6 and 63.2 for vision–related dependency and 76.4 and 69.3 for peripheral vision, respectively.
Conclusions: :
Despite cataract surgery, a significant proportion of participants had residual visual impairment. Refractive correction eliminated visual impairment in 20% of these individuals, demonstrating the need for regular ophthalmologic exams and refraction in cataract–operated patients. Participants in the PPHKC group are likely to show improvement in vision–specific QOL after cataract extraction in the unoperated, cataractous "second" eye.
Keywords: quality of life • cataract • clinical (human) or epidemiologic studies: outcomes/complications