Visual acuity and quality of life in patients with cataract in Doumen County, China

Purpose: To evaluate the effectiveness of cataract surgery in achieving sig ht restoration and vision-related quality-of-rife (QOL) in patients from ru ral southern China. Design: Population-based, cross-sectional study. Participants: A total of 109 cataract operated persons (152 eyes) and 654 u noperated persons. Methods: Cluster sampling was used in identifying a random sample of 5342 p ersons 50 years of age and older for visual acuity and eye examinations. Vi sual functioning (VF) and QOL questionnaires were administered to aphakic a nd pseudophakic individuals, unoperated persons with presenting visual acui ty less than 0.10 in either eye, and a sample of those with normal vision. Main Outcome Measures: Distance visual acuity, VF, and QOL questionnaire sc ores. Results: Among the cataract operated participants, 43 (39.4%) were bilatera lly operated on, 32.1% had presenting visual acuity less than 0.10 in both eyes with 8.3% greater than or equal to 0.32 in both eyes. Of operated eyes , 52.6% presented with visual acuity less than 0.10, 23.7% greater than or equal to 0.32; with best correction, the corresponding percentages were 21. 1% and 42.1%. Uncorrectable aphakia due to surgical complications was commo n. In a multivariate regression model, better visual acuity outcomes were a ssociated with higher level surgeon practice settings and recent surgery. O n a 0 to 100 scale, mean VF and QOL scores for the cataract operated popula tion were 41.6 and 54.5, respectively. Mean scores ranged from 84.4 and 93. 4, respectively, for the unoperated persons with normal vision, to 14.6 and 31.2, respectively, for those with visual acuity less than 0.05 in both ey es, The VF and QOL scores were closely correlated with presenting visual ac uity in both cataract operated and unoperated populations (r = 0.49-0.64). Scores among the cataract operated population were not influenced by age, g ender, or education level. Among the unoperated population, lack of educati on was associated with lower VF and QOL scores (P = 0.017 and P = 0.005, re spectively), and older age was associated with lower QOL scores (P < 0.001) . Conclusion: Patients in rural southern China are not realizing the full sig ht-restoring potential of modern-day cataract surgery, Remedial efforts are needed to improve the performance of local eye surgeons.