Visual outcomes and vision-related quality of life in veterans with systemic comorbidities: Results from the Veterans Affairs Ophthalmic Surgery Outcomes Data Project

Abstract

Purpose : To analyze visual acuity outcomes and functional visual improvement after cataract surgery in veterans with systemic comorbidities.

Methods : We analyzed 3154 of 4,923 cataract surgery cases, either without (Group A) or with systemic comorbidities (Group B), who completed both pre- and postoperative National Eye Institute-Visual Function Questionnaire (NEI-VFQ 25), in the Veterans Affairs (VA) Ophthalmic Surgical Outcomes Data (OSOD) Project. The systemic comorbidities included diabetes, hypertension, peripheral vascular disease, chronic obstructive pulmonary disease, congestive heart failure, current acetylsalicylic acid/other anti-coagulant use, history of smoking, recreational drug use and alcohol >2 drinks per day. The two groups were compared on best-corrected visual acuity (BCVA, logMAR scale) and all NEI-VFQ 25 subscales. Data were analyzed using analysis of variance and nonparametric tests. Correlation was estimated using Pearson’s correlation coefficient.

Results : One hundred and twelve (3.6%) of 3154 cases were in Group A, 3041 (96.4%) cases were in Group B, and 1 (0.03%) had missing data. BCVA improved significantly from pre-to post-surgery in Group A (0.05 ± 0.19, P<.0001) and in Group B (0.08 ± 0.23, P<.0001). There was more improvement in BCVA in Group A from pre-to post-surgery than in Group B (P=.004). VFQ composite scores increased significantly from pre- to post-surgery in Group A (87.3 ± 14.4, P<.0001), as well as in Group B (83.4 ± 17.2, P<.0001). The improvement in VFQ composite scores in Group A was comparable to improvement in Group B (P=.12). For veterans in Group A, the improvements in vision and vision-related quality of life (VRQoL) were not correlated significantly (Pearson’s r=0.02, P=0.85) while for Group B the correlation was significant (r =0.17, P<.0001).

Conclusions : Cataract surgery offers significant improvement in vision and VRQoL for eyes in both groups. Veterans without systemic comorbidities had greater gains in visual acuity post-surgery than those with systemic comorbidities in our study, although the gains in VRQoL were comparable in both groups.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.