ABSTRACT: To study the influence of congenital bilateral cataract on visual-related quality of life (QoL) in children.
The scale of QoL for children with congenital bilateral cataract was used to evaluate the QoL of 81 children with congenital bilateral cataract and 28 healthy children with normal visual acuity. The average age of congenital bilateral cataract candidates was 9.8 years (from 8 to 15 years) and 37 patients were female. Thirty-six cataract children took part in the both preoperative and postoperative investigations. The patients' QoL were also categorized by age, gender, score, visual acuity, surgery and density of cataract. Multiple-linear regression model was applied to analyze the influence factors of QoL.
Statistically significant difference was found at the QoL between healthy children and children with congenital bilateral cataract (P = 0.00). The QoL in children with non-dense cataract was increased after cataract surgery (P = 0.00). A high correlation was found between visual acuity and QoL (r = 0.53, P = 0.00). A statistically significant difference was found in QoL between dense and non-dense cataract (P = 0.00). Three variances enrolled in the multiple-linear regression equation included the density of cataract, surgery and visual acuity. Their partial regression coefficients were 6.14 (P = 0.00), 3.21 (P = 0.01) and 1.07 (P = 0.01) respectively.
Compared with the healthy children, the QoL score was severely impaired in children with congenital bilateral cataract, which was influenced by the density of cataract, surgery and visual acuity. Visual acuity is the most critical factor influencing the QoL.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 12/2007; 43(11):996-9.
ABSTRACT: Dense congenital cataracts often cause severe visual impairment. The results of long-term follow-up of dense bilateral congenital cataract in China have not been well documented. The purpose of this study was to evaluate the long-term visual function in children who underwent cataract extraction for dense bilateral congenital cataract in southern part of China.
Medical records of children who underwent surgery of dense bilateral congenital cataract between January 1992 and December 2000 at Zhongshan Ophthalmic Center of Sun Yat-sen University were retroactively reviewed. In 38 children available for current follow-up, best corrected visual acuity (BCVA) and stereoscopic vision, as well as nystagmus, strabismus, and other complications, were evaluated. The mean follow-up period was 107.6 months (range 60 to 167 months).
The mean age of cataract extraction and secondary intraocular lens implantation were 5.6 months (range 3 to 12 months) and 4.2 years (range 2.4 to 15 years), respectively. The mean BCVA was 0.25 in the better eye and 0.16 in the fellow eye. Stereoscopic vision was absent in all patients, and 3 children had simultaneous perception. Nystagmus was detected in all cases and strabismus in 35 cases. A high correlation was found between timing of cataract extraction and final BCVA of the better eye (r = -0.55, P = 0.00). A statistically significant difference was found in BCVA between post- and pre-treatment of amblyopia (t = 5.65, P = 0.00).
Long-term visual function in children with dense bilateral congenital cataract was poor when cataract surgery was performed at age of 3 months or later. Earlier cataract surgery with adequate optical rehabilitation contributed to better visual outcome.
Chinese medical journal 10/2007; 120(17):1494-7. · 0.86 Impact Factor
ABSTRACT: To develop and evaluate the 23-item quality of life (QoL) 125 scale contained four subscales for children with bilateral congenital cataract.
18 children with normal visual acuity and 76 patients with congenital bilateral cataract (age range of 8 years to 15 years) were evaluated with QoL. The 23-item QoL scale contained the following subscales: visual function, self-care, sociality, and mentality. Dispersion, correlation coefficient, factor analysis, discrimination analysis, Cronbach alpha and test-retest reliability were applied to select the parameters and data analysis.
The new scale included 20 items after screening. The correlation coefficients of content validity of each item and subscale were beyond 0.6 (P < 0.05). Statistically significant difference was found at discrimination analysis between normal and cataract children (P' = 0.000), the differences was also demonstrated between preoperative and postoperative cataract children (P' = 0.000). The coefficient of test-retest reliability was 0.895 (P = 0.000), and the Cronbach's alpha coefficients of four subscales were 0.822, 0.922, 0.797, and 0.794 respectively. The statistics value of effective size was 1.141.
significant reliability, validity and responsibility to change life quality were achieved in the 20-item scale of QoL for children with bilateral congenital cataract. This scale can be applied to evaluate the life quality of bilateral cataract children.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 03/2007; 43(3):239-44.
ABSTRACT: The advent of wavefront technology in the past five years has provided some insight into the optical outcomes of cataract surgery. The Tecnis Z9001 intraocular lens (Tecnis IOL, AMO) with a modified prolate anterior surface was claimed to reduce or even eliminate ocular spherical aberration to improve the visual quality. The purpose of this study was to determine whether Tecnis IOLs can improve the quality of vision as evaluated by measuring visual acuity, wavefront aberration, and contrast sensitivity.
In an intraindividual prospective study, 20 patients with bilateral cataract were randomly assigned to receive a modified prolate anterior surface IOL (Tecnis Z9001, AMO) in one eye and a biconvex spherical surface IOL (CeeOn 911A, AMO) in the other. After 3 months, the following were investigated: best corrected visual acuity, pupil diameter, photopic and mesopic contrast sensitivity, and wavefront aberration of the whole eye (ocular), cornea, and internal plane.
The differences in the best corrected visual acuity and pupil diameter between the two groups were not statistically significant. Negative 4th-order spherical aberration (Z(4)(0)) was found in the Tecnis group, whereas positive Z(4)(0) found in the CeeOn group for the internal and ocular plane. Statistically significant differences were found at the ocular higher-aberrations between the two IOLs. Contrast sensitivity testing showed significantly better results in the Tecnis group at visual angles higher than 1.0 degree under photopic conditions and at visual angles higher than 1.6 degree under mesopic conditions both without glare and with glare in comparison with the CeeOn group.
The Tecnis Z9001 IOL with a modified prolate anterior surface produces negative spherical aberration and consequently reduces the higher-order aberrations in pseudophakic eyes. This leads to enhanced contrast sensitivity and improved functional vision compared to conventional spherical IOLs.
Chinese medical journal 12/2006; 119(21):1779-84. · 0.86 Impact Factor