Abstract
Abstract: :
Purpose: Patients in the United Kingdom who require cataract surgery may have to wait in some instances for up to a year for their surgery. The government has plans to significantly reduce this wait and there is a need to prioritise those patients who have severe visual disability from cataract to allow them to undergo surgery as soon as possible. Previous scoring systems have relied heavily on visual acuity scoring as a determinant factor. The VCMI score was developed as a self-administered scoring system to measure visual impairment in the community. We have used this scoring system to measure the visual disability in patients before and after their cataract surgery. Method: The VCMI questionnaire was administered pre-operatively to 227 patients, 3 to 4 weeks prior to cataract surgery irrespective of whether they were undergoing first or second eye surgery. 210 questionnaires were sent to patients post-operatively and were completed once best-corrected visual acuity was obtained. Results: 178 post-operative questionnaires were received, a return rate of 78%. Numbers of patients with the scores pre and post-operatively are listed in the table. The mean postoperative scores were significantly lower than that scored preoperatively, p<0.0001, indicating a significant improvement in vision-related quality of life from cataract surgery. Patients were divided into three groups, according to their preoperative scores:- 0-0.9, 1.0-2.9 and 3.0-5.0. The mean difference in scores (post operative versus preoperative) between the groups, 0-0.9 was -0.06, 1.0-2.9 was 0.88 and 3.0-5.0 was 2.00 and was found to differ significantly, p<0.001. Patients with higher preoperative scores gain significantly more benefit from cataract surgery. Conclusion: The VCMI questionnaire is a rapidly and easily administered to assess visual impairment. The scoring system has not previously been used to assess patients with known pathology. The results suggest that the scoring system has potential as a prioritization instrument for cataract surgery. Pre and post -operative VCMI scores
Keywords: 338 cataract • 536 quality of life • 620 visual acuity