Abstract
ObjectiveDetermine whether items in a cataract surgery appropriateness and prioritization questionnaire can predict change in best corrected visual acuity (BCVA) and health related quality of life (HRQOL) following cataract surgery.Methods313 patients with a cataract in Ontario, Canada were recruited to participate. BCVA was measured using the Snellen chart. HRQOL was measured using a generic instrument (EQ5D), a visual functioning instrument (Catquest-9SF), and an appropriateness and prioritization instrument (17 items). Outcomes were measured preoperatively and 3–6 months postoperatively. Descriptive statistics were used to describe demographics and outcomes. For each appropriateness and prioritization questionnaire item, a one-way ANOVA was used to compare group means of the change in BCVA, EQ5D, and Catquest-9SF.ResultsParticipants had a mean age of 69 years and were 56% female. BCVA improved in 81%, EQ5D in 49.6%, and Catquest-9SF score in 84% of patients. Improvement in both BCVA and Catquest-9SF scores were found in 68.5% of patients. The ANOVA showed a statistically significant association between a change in BCVA and the ability to participate in social life, and a statistically significant association between a change in Catquest-9SF and glare, extent of impairment in visual function, safety and injury concerns, ability to work and care for dependents, ability to take care of local errands, ability to assist others and ability to participate in social life.ConclusionsAlmost all patients had improved BCVA and/or visual functioning after surgery. Seven variables from the cataract appropriateness and prioritization instrument were found to be predictors of improvement in Catquest-9SF measuring visual functioning.
Highlights
Cataract remains the leading cause of blindness and vision loss in the world
best corrected visual acuity (BCVA) improved in 81%, EQ5D in 49.6%, and Catquest-9SF score in 84% of patients
The ANOVA showed a statistically significant association between a change in BCVA and the ability to participate in social life, and a statistically significant association between a change in Catquest-9SF and glare, extent of impairment in visual function, safety and injury concerns, ability to work and care for dependents, ability to take care of local errands, ability to assist others and ability to participate in social life
Summary
Cataract remains the leading cause of blindness and vision loss in the world. Visual impairment impacts an individual’s quality of life by hindering their ability to perform daily living activities, to work and to care for dependents [1]. Reduced vision can lead to an increase in fall-related injuries and fractures where 20% can result in hospitalizations [2]. These deleterious effects will differ from patient to patient depending on the severity of the cataract. Cataract blindness is rare in economically developed countries because there is greater access to cataract surgery. The demand for cataract surgery, has increased dramatically due to the rising prevalence of cataracts in the aging population, so that, across many countries in the developed world, surgical capacity will likely not grow fast enough to keep up with this growing demand [3]. In Ontario Canada, projections for cataract demand will increase between 72%-144% in the 25 years [3, 4] but there will be substantially slower growth of publically-funded outpatient operative capacity
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