Determinants of vision function related quality of life of patients undergoing unilateral cataract surgical services in charitable hospitals in India: a multicentre prospective cohort study

Abstract

Background: Cataract is the leading cause of avoidable blindness in developing world, including India. The objective of this study is to measure the changes in quality of life (VRQoL) after cataract surgery and identify the predictors of an improvement in these outcomes.Methods: A multi-center prospective, longitudinal cohort study was conducted. At baseline patients aged ≥18 years with first-eye cataract were interviewed about VRQoL. Six months’ later participants were re-interviewed at their residences. Multiple classification analysis (MCA) was performed to assess the variation in the intensities of mean change scores for general function, psychosocial impact and visual function with select factors.Results: The six-month follow-up rate was 87.3%. There was a significant improvement in visual acuity and VRQoL post-surgery. The mean general function, psychosocial impact and visual function scores were 34.6 (SD 10.9), 10.5 (SD 3.7) and 8.4 (SD 2.2) in the baseline and 15 (SD 5.5), 5 (SD 2.2) and 4.4 (SD 1.6) in the follow-up assessments, respectively. In MCA, patients prescribed spectacles post-surgery (β 0.137) and those from rural backgrounds (β 0.137) had the most impact on general function. Patients with complete follow-up visits had a relatively higher effect on the psychosocial impact (β 0.084) whereas patients from rural background and men had the most impact on the visual function scores (β 0.102 and 0.076) respectively.Conclusions:Cataract surgery is associated with meaningful improvements in VRQoL in general. The determinants of better VFQoL include regular and complete patient follow-up visits and prescription and provision of spectacles post-surgery.