GAINS FROM CATARACT-SURGERY - VISUAL FUNCTION AND QUALITY-OF-LIFE

Aims-To describe the impact of cataract surgery in terms of visual fun ction (functioning in everyday Life with respect to vision dependent a ctivities) and health related quality of life. Methods-An observationa l, longitudinal study of patients undergoing cataract surgery was carr ied out at three district general hospitals in outer London districts of North Thames Region with follow up at 4 and 12 months postoperative ly for a clinical assessment and a standardised administered interview . Patients were admitted for surgery to the first eye for age-related cataract between 1 May 1993 and 31 August 1994. Visual functioning was assessed by the VF-14, health related quality of life was assessed by the sickness impact profile (SIP), and vision related quality of Life was assessed by VR-SIP (a modification of the generic SIP). Results-S ignificant gains in all the outcome measures were demonstrated at 4 mo nths postoperatively. No significant change (gain or loss) was observe d between 4 and 12 months after surgery to the first eye. Postoperativ ely, the mean visual function (VF-14) scores, and health related (SIP) and vision related (VR-SIP) quality of life scores, indicated less re ported trouble with vision dependent activities and better perceived q uality of Life, respectively. The average gains in visual function and quality of life (health and vision related) were apparent in groups w ith good visual outcome and poor visual outcome. Significant additiona l gains were seen at 1 year in patients who had second eye surgery in the interval between the postoperative assessments. Conclusions-Gains in visual functioning and quality of life (health and vision related) have been demonstrated following cataract surgery. These gains were su stained at 1 year after surgery to the first eye, with additional gain s being conferred if second eye surgery had been performed. Assessment of the outcomes of cataract surgery by clinical indicators alone may underestimate the overall benefits of surgery, particularly in patient s with poor visual outcome.