A Multicenter Prospective Cohort Study of Quality of Life and Economic Outcomes after Cataract Surgery in Vietnam: The VISIONARY Study

Abstract

To measure the change in quality of life and economic circumstances after cataract surgery and identify the predictors of an improvement in these outcomes. A multicenter, prospective, longitudinal cohort study. Participants aged 18 years were recruited to the study if the clinical assessment of their best uncorrected vision was <= 6/18 in the better eye because of cataract [Corrected]. Cataract surgery. Data were collected on quality of life and a multidimensional assessment of household economic circumstances (work status, income, asset ownership, household economic hardship, and catastrophic health expenditure). At 12 months follow-up, 381 of 480 participants were re-interviewed, and all had undergone surgery. There was a significant improvement in quality of life. Household economic circumstances also improved (mean change paid work participation/month: 44.5 hours, P < 0.0001; mean change unpaid work participation/month: 89.5 hours, P < 0.0001; change in proportion with hardship: -17%, P < 0.0001; and change in proportion with catastrophic health expenditure: -7%, P = 0.02). Improvements were most likely in near-poor households and were related to the type of surgery and complications after surgery. This research showed that cataract surgery is associated with meaningful improvements in quality of life and household economic circumstances that are indicative of positive transitions out of poverty. Given the unmet need for cataract surgery in low- and middle-income countries where cataract impairment is substantial, this research demonstrates the potential of a relatively simple, low-cost health intervention to greatly improve household economic circumstances.