Abstract
BackgroundTo validate the Catquest-9SF questionnaire in Italian, assess the change in visual disability with cataract surgery and determine the correlation between pre-operative Catquest-9SF scores and Lens Opacities Classification System (LOCS) III cataract grading.MethodsProspective, questionnaire validation study. The Catquest-9SF questionnaire was forward and back translated and completed by 209 Italian patients before and three months following cataract surgery. Rasch analysis was used to assess its psychometric properties.ResultsThe Italian Catquest-9SF demonstrated ordered response categories, unidimensionality (item fit statistics range: 0.73–1.34), adequate person separation (2.04), and no differential item functioning. Mistargeting was evident with a mean difference in item difficulty and person ability of 2.04 logits but improved with inclusion of pre-operative data only. There was a statistically significant (Friedman tests, p < 0.001) median improvement in visual disability of 1.92, 3.57, 1.44 and 2.94 logits in patients undergoing first eye surgery with and without ocular comorbidity, and second eye surgery with and without ocular comorbidity respectively. There was no statistically significant difference in the improvements among the four groups (Kruskal-Wallis H test, X2(3) = 5.445, p = 0.142). There was no correlation between Catquest-9SF scores and nuclear opalescence (rs = 0.049, p = 0.478), nuclear colour (rs = 0.008, p = 0.909), cortical (rs = 0.066, p = 0.341), and posterior subcapsular components (rs = 0.048, p = 0.494).ConclusionsThe Italian Catquest-9SF demonstrated good psychometric properties and is suitable for use in Italian speaking patients. There were similar improvements in visual disability in patients undergoing first or second eye surgery, with or without ocular comorbidity. There was no correlation between pre-operative Catquest-9SF scores and LOCS III cataract grading.
Highlights
To validate the Catquest-9SF questionnaire in Italian, assess the change in visual disability with cataract surgery and determine the correlation between pre-operative Catquest-9SF scores and Lens Opacities Classification System (LOCS) III cataract grading
Three patients had complicated surgery and were excluded from the subsequent analysis; the data from 209 eyes were included in the analysis
There was no correlation between Catquest-9SF scores and nuclear opalescence, nuclear colour, cortical, and posterior subcapsular
Summary
To validate the Catquest-9SF questionnaire in Italian, assess the change in visual disability with cataract surgery and determine the correlation between pre-operative Catquest-9SF scores and Lens Opacities Classification System (LOCS) III cataract grading. Determining the success of the operation is of the utmost importance. Whilst objective measures such as visual acuity and residual refractive error are important outcomes from the surgeon’s perspective, the ability to perform day-to-day tasks is one of the most important outcomes from the patient’s perspective. It is important to note that some patients, who have had uneventful cataract surgery with gains in visual acuity, may still not be satisfied [8]. This may be due to a variety of complex reasons such as patient expectations and doctor-patient communication [9].
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