Influence of bilateral cataract surgery on vision–related quality of life

Abstract

Abstract: : Purpose: : To investigate the impact of bilateral cataract surgery on vision–related quality of life, as measured by the 25–item National Eye Institute Visual Functioning Questionnaire (NEI–VFQ25). Methods: NEI–VFQ25 is the measure designed to assess vision–related functioning and the influence of vision problems on health–related quality of life, which has been translated and validated in Japanese language. Subjects were 110 patients undergoing bilateral cataract surgery (70.4 ± 9.2 years old), consisting of phacoemulsification and implantation of foldable intraocular lenses. Best–corrected visual acuity was 20/30 or worse in both eyes. NEI–VFQ25 was recorded before and 2 months after surgery. Results: NEI–VFQ25 scores before cataract surgery was severely impaired, as low as the scores obtained in glaucoma patients with visual field defects in both eyes. Cataract surgery significantly improved NEI–VFQ25 scores nearly up to the level of age–matched normal controls. Statistically significant improvements were observed in those items such as general vision, near activities, distance activities, driving, color vision, peripheral vision, social functioning, mental health, role difficulties, dependency (p<0.001, paired t–test). Scores for ocular pain/discomfort did not change significantly by surgery. The degree of improvements in VFQ25 scores did not correlate with preoperative or postoperative visual acuity. Patients with posterior subcapsular cataract showed greater improvement, and VFQ25 scores improved more in younger patients (Pearson r=–0.325, p=0.0099). Conclusions: The current prospective study quantitatively demonstrated that vision–related QOL is significantly impaired in patients with cataract, and that cataract surgery dramatically improves patients’ QOL.

Keywords: cataract • quality of life • vision and action