Quality of life and patient satisfaction after cataract surgery. Results of an observational study between 04/2001 and 06/2002

Abstract

Assessment of patient satisfaction and quality of life becomes increasingly important for the overall evaluation of therapy regimes. However, it is not certain whether standard quality of life questionnaires suffice to assess immediate changes in patient conditions such as induced by cataract surgery. The increase in visual acuity was observed in 152 cataract patients as an objective efficacy parameter. In addition, subjective patient satisfaction and quality of life was obtained from these patients by means of a cataract-specific questionnaire 1 day before and 4 weeks after surgery. The questionnaire concentrates on the patients' overall flexibility and mobility, their estimation of medical and nursing care, changes in ophthalmological conditions and on complications after surgery. With an internal consistency of 82% the instrument can be regarded as moderately reliable but self-reported quality of life before surgery was found to be remarkably biased. None of the above quality of life determinants showed a clinically relevant correlation with the objective increase in visual acuity (absolute correlations <20%). Significant impact factors for overall quality of life satisfaction were the patients' overall flexibility ( p=0.049) and their estimation of medical and nursing care ( p=0.027). Standard quality of life determinants provide independent subjective information in addition to the increase in visual acuity as an objective measure of clinical outcome. Overall assessment of patient satisfaction cannot be regarded as sufficient for the subjective evaluation of cataract surgery, since its estimation primarily depends on the patients' appreciation of medical and nursing care. An appropriately extensive means of quality of life assessment seems necessary and post-surgical data seems sufficient for the estimation of subjective therapy outcome measures in cataract patients.