Subjective Quality of Vision Before and After Cataract Surgery
ABSTRACT OBJECTIVE To investigate the effect of cataract surgery on subjective quality of vision. METHODS The Quality of Vision (QoV) questionnaire (Italian translation) was completed before and 3 months after cataract surgery in 4 groups of patients recruited from September through December 2010: first eye with ocular comorbidity, first eye without ocular comorbidity, second eye with ocular comorbidity, and second eye without ocular comorbidity. The questionnaire measures 3 aspects of quality of vision: frequency, severity, and bothersome nature of symptoms. The Lens Opacities Classification System (LOCS) III was used for cataract grading. Friedman and Kruskal-Wallis H tests were performed to compare QoV scores within and between groups. Spearman rank correlations (rs) were calculated to investigate the correlation between LOCS III and QoV symptoms. RESULTS Two hundred twelve patients (mean [SD] age, 74.2 [8.7] years) were recruited, and 212 eyes were included in the study. Improvements in QoV scores were found in all 4 groups (P < .05). There were no statistically significant (P > .05) differences among the 4 groups in the improvement in QoV scores or in the preoperative or postoperative scores. Blurred vision was correlated with posterior subcapsular cataract (rs = 0.420, P = .04). CONCLUSIONS Cataract in one or both eyes causes a similar loss in subjective quality of vision, which is also irrespective of the presence of ocular comorbidity. Posterior subcapsular cataract causes the specific symptom "blurred vision." Cataract surgery resulted in a large and comparable improvement in subjective quality of vision, regardless of ocular comorbidity and first or second eye surgery.
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ABSTRACT: To compare postoperative visual symptoms and spectacle freedom after bilateral implantation of the AT LISA 809M (Carl Zeiss Meditec, Jena, Germany) versus the AcrySof ReSTOR SN6AD1 (Alcon Laboratories, Irvine, CA) multifocal intraocular lens (IOL). Double-masked, prospective, randomized, controlled clinical trial. A total of 188 patients undergoing bilateral sequential cataract surgery or bilateral refractive lens exchange. Patients were preoperatively randomized (allocation ratio 1:1) to bilateral implantation with the AT LISA 809M IOL or ReSTOR SN6AD1 IOL. Postoperative outcomes were assessed 4 to 8 months after second eye surgery. The primary outcome was visual symptoms evaluated with the Quality of Vision (QoV) questionnaire. Secondary outcomes included other questionnaire data (CatQuest-9SF, spectacle independence, vision satisfaction, and dysphotopsia) and visual function measures (near, intermediate, and distance visual acuity, binocular reading speed [International Reading Speed Texts], contrast sensitivity, and forward light scatter). Adverse events, including intraoperative and postoperative complications, also were evaluated. There was no significant difference between IOL groups in Rasch-adjusted QoV scores for frequency (P = 0.95), severity (P = 0.56), and bothersomeness (P = 0.34) of visual symptoms; median (interquartile) scores for these QoV subscales were 29 (15-37), 22 (13-27), and 14 (0-29) for the AT LISA 809M IOL group, respectively, and 32 (15-37), 22 (13-30), and 14 (0-29) for the ReSTOR SN6AD1 IOL group, respectively. Halo was the most prominent dysphotopsia symptom, with 6% in both IOL groups reporting halo symptoms as very bothersome. Complete spectacle independence was achieved in 69 of 84 (82.1%) AT LISA 809M recipients and 66 of 85 (77.6%) ReSTOR SN6AD1 recipients (P = 0.57). Preferred reading distance was slightly nearer for the AT LISA 809M IOL. There were no statistically significant differences in any of the other secondary outcome measures. Visual symptoms were similar after bilateral implantation of the AT LISA 809M and ReSTOR SN6AD1 IOLs. Both these diffractive bifocal IOLs produce high levels of spectacle independence and patient satisfaction. However, a small but clinically significant minority of patients remained symptomatic and dissatisfied with visual results 4 to 8 months after surgery. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.Ophthalmology 12/2014; DOI:10.1016/j.ophtha.2014.10.002 · 6.17 Impact Factor
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ABSTRACT: Background Visual impairment (VI) affects physical, psychological, and emotional well-being, and social life as well. The purpose of this exploratory study was to assess the psycho-social impact of VI on health-related quality of life (HRQoL) among nursing home residents. Methods This cross-sectional study involved 272 residents of 60 years or older residing in seven nursing homes of the Kathmandu Valley, Nepal. Comprehensive ocular examinations, including near and distance vision assessment and refractions were carried out. VI was defined as visual acuity (VA) less than 6/18 in the better eye. Residents were divided into two groups: one group did not have VI (in whom VA was greater than or equal to 6/18 in the better eye), and the other had VI (in whom VA was worse than 6/18 in the better eye). Face-to-face interviews were conducted filling out a 36-item The Medical Outcomes Study Short-Form (SF-36) questionnaire. The SF-36 questionnaire was scored according to the scoring algorithm SF-36 subscales. Results The mean age of residents was 74.68 +/- 8.19 years (range, 60-99 years) and the majority were female (78.68%). The mean composite score of SF-36 was 46.98 +/- 13.08. VI detrimentally affected scores of both the physical and the mental components, but the impact of VI was slightly greater for the physical component than that for the mental component. There was a trend towards a lower composite score as well as each subscale score of the SF-36 in participants with VI than in those without VI. Conclusion VI has a negative effect on HRQoL. HRQoL is reduced among nursing home residents and the reduction in the HRQoL bears a positive association with VI.BMC Health Services Research 08/2014; 14(14):345. DOI:10.1186/1472-6963-14-345 · 1.66 Impact Factor
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ABSTRACT: The aim of this study is to assess the agreement of IOL power and ocular biometry measurements before and after pupillary dilatation by using the IOLMaster. This was the prospective nonrandomized cohort study. Measurements were taken with the IOLMaster (®) (Carl Zeiss Meditec AG, Jena, Germany) from healthy volunteers at the Department of Ophthalmology, King Chulalongkorn Memorial Hospital. Axial length (AL), keratometry both flattest and steepest (K1, K2), and anterior chamber depth (ACD) were measured before and after the dilatation of the pupil with 1 % tropicamide. The IOL power was calculated using the Sanders-Retzlaff-Kraff/Theoretical (SRK/T) formula. The mean difference of each parameter was assessed by Bland-Altman plot analysis. 384 eyes from 195 healthy volunteers were measured. The mean age of the patients was 52.39 ± 1.02 years (range 21-79). Pupillary dilatation had no significant effect on AL (p = 0.07), keratometry [steepest K (p = 0.95) and flattest K (p = 0.17)], and IOL power (Alcon SN60WF) (p = 0.40) obtained from the IOLMaster. However, ACD was significantly increased post-dilatation (p < 0.05). The Bland-Altman plot indicated good concordance in nearly all parameters except ACD. For ACD measurements, the 95 % limit of agreement between pre-dilatation and post-dilatation was -0.47 to 0.23 mm; therefore, 92.2 % of the measurement differences were with a LoA of -0.47 to 0.23 mm. There were no eyes that could not be measured by the IOLMaster. The dilatation of the pupil had no significant effect on AL, keratometry measurements, and SRK/T calculated IOL power. However, the ACD significantly increased post-dilatation.International Ophthalmology 03/2015; DOI:10.1007/s10792-015-0063-9 · 0.55 Impact Factor