Abstract
Purpose :
To describe a novel approach to capturing patient-reported function after cataract or glaucoma surgery
Methods :
Patients undergoing trabeculectomy, tube shunt, or cataract extraction (CE) evaluated their postoperative recovery via visual analog scales (VAS) grading pain and global function, plus questions about daily tasks. Items were evaluated daily for the first two post-operative weeks and weekly thereafter. Data were collected on participants’ medical history and visual ability, and surgical video was reviewed to assess procedure details. Multiple linear regression models evaluated whether VAS scores for function differed across surgery type at post-operative day 1 (POD1). Generalized estimating equation models were used to evaluate change in VAS score for function over time for each surgery type. Age, race, gender, participant comorbidities, and glaucoma severity represented by visual field mean deviation in the better eye were treated as covariates.
Results :
Forty-nine participants (n=17, 15, 17 for CE, trabeculectomy, and tube shunt, respectively) all self-reported reduced global function on post-operative day 1 (POD1) using a VAS. Compared to CE, tube shunt placement reduced POD1 function by 44.4% (p=0.003), while trabeculectomy did not reduce POD1 function significantly more than CE (p=0.68). Following CE, VAS scores increased an average of 1.40% per day (p<0.001) for 14 days. Following trabeculectomy, scores increased an average of 0.51% per day (p=0.02) for 21 days. Following tube shunt placement, scores increased an average of 1.04% per day (p<0.001) for 60 days. Beyond these points, there was no further significant change in VAS scores for function.
Conclusions :
Patients recovering from cataract and glaucoma surgery asked to document their activity, pain, and function all report reduced global function in the immediate post-operative period. Tube shunt implantation appears to cause significantly greater post-operative morbidity than trabeculectomy, while both are associated with longer recovery and slower rates of functional improvement than CE. A VAS, a well-validated approach for capturing pain, may also meaningfully reflect patient-reported function and prove an efficient means of capturing post-operative recovery dynamics.
This is a 2020 ARVO Annual Meeting abstract.