Purchase this article with an account.
C Owsley, G McGwin, K Scilley, J Brown; Impact of Cataract Surgery on Self-Reported Visual Task Difficulties: Comparison to a No-Surgery Reference Group . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1516.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To examine the impact of cataract surgery on older adults' self-reported visual difficulties, as compared to those with cataract who did not elect surgery. Many studies have examined questionnaire responses using a pre-/post cataract surgery study design, but prior studies have not compared results against a non-surgical cataract group followed over the same timeframe. Method: Patients with cataract were recruited from 12 practices in Birmingham AL by consecutive chart review over a 6-mo period. Inclusion criteria included at least 55 yo, cataract in one or both eyes with 20/40 VA or worse (best-corrected, distance), no prior cataract surgery in either eye, and independent community dweller. The Activities of Daily Vision Scale (ADVS) and tests of visual acuity, contrast sensitivity, and disability glare were administered at baseline and one-year follow-up. For those persons electing cataract surgery, the baseline visit was before the first eye surgery. Results: A total of 245 patients enrolled, with 156 electing and 89 declining surgery during the observational period. Those electing surgery were more likely to be white, female, have worse vision, and no ocular comorbidities. At baseline, mean ADVS subscale scores ranged from 53-76 for the Surgery group; for the No-Surgery group, from 72-89. For the Surgery group, subscale scores improved by 15-21 points on average at post-surgery annual follow-up, whereas ADVS scores were unchanged for the No-Surgery group over the same time period. This differential ADVS score change in the two groups remained statistically significant after adjustment for group baseline differences in demographics, vision, and ADVS score. Cataract surgery demonstrated the strongest association with change in overall ADVS scores accounting for 25% of the total variance. Improvement in visual acuity was an independent predictor of improvement in ADVS score among surgery patients, but improvements in contrast sensitivity and disability glare were not. Conclusions: Cataract patients who elect surgery report more difficulty in visual tasks than do those who decline surgery. Following surgery, patients report less difficulty in visual tasks; approximately 25% of this change (i.e. improvement) is attributable to the cataract surgery intervention itself. Improvements in ADVS score are linked to improvements in visual acuity.
This PDF is available to Subscribers Only