Focussing Both Eyes on Health Outcomes: Revisiting Cataract Surgery

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2012 Sep 5

PMID 22943071

Citations 4

Authors

Jennifer C Davis

Heather McNeill

Michael Wasdell

Susan Chunick

Stirling Bryan

Affiliations

Soon will be listed here.

Abstract

Background: The appropriateness of cataract surgery procedures has been questioned, the suggestion being that the surgery is sometimes undertaken too early in the disease progression. Our three study questions were: What is the level of visual impairment in patients scheduled for cataract surgery? What is the improvement following surgery? Given the thresholds for a minimal detectable change (MDC) and a minimal clinically important difference (MCID), do gains in visual function reach the MDC and MCID thresholds?

Methods: The sample included a prospective cohort of cataract surgery patients from four Fraser Health Authority ophthalmologists. Visual function (VF-14) was assessed pre-operatively and at seven weeks post-operatively. Two groups from this cohort were included in this analysis: 'all first eyes' (cataract extraction on first eye) and 'both eyes' (cataract removed from both eyes). Descriptive statistics, change scores for VF-14 for each eye group and proportion of patients who reach the MDC and MCID are reported.

Results: One hundred and forty-two patients are included in the 'all first eyes' analyses and 55 in the 'both eyes' analyses. The mean pre-operative VF-14 score for the 'all first eyes' group was 86.7 (on a 0-100 scale where 100 is full visual function). The mean change in VF-14 for the 'both eyes' group was 7.5. Twenty-three percent of patients achieved improvements in visual function beyond the MCID threshold and 35% saw improvement beyond the MDC.

Conclusions: Neither threshold level for MDC or MCID for the VF-14 scale was achieved for a majority of patients. A plausible explanation for this is the very high levels of pre-operative visual functioning.

Citing Articles

Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery.

Xue W, Zhang P, Zou H Int J Ophthalmol. 2019; 12(3):504-509.

PMID: 30918822 PMC: 6423376. DOI: 10.18240/ijo.2019.03.23.

Assessment of Cataract Surgery Outcome Using the Modified Catquest Short-Form Instrument in China.

Khadka J, Huang J, Chen H, Chen C, Gao R, Bao F PLoS One. 2016; 11(10):e0164182.

PMID: 27736889 PMC: 5063336. DOI: 10.1371/journal.pone.0164182.

Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review.

Pinazo-Duran M, Zanon-Moreno V, Garcia-Medina J, Fernando Arevalo J, Gallego-Pinazo R, Nucci C Biomed Res Int. 2016; 2016:6215745.

PMID: 27051666 PMC: 4808667. DOI: 10.1155/2016/6215745.

Indication for cataract surgery. Do we have evidence of who will benefit from surgery? A systematic review and meta-analysis.

Kessel L, Andresen J, Erngaard D, Flesner P, Tendal B, Hjortdal J Acta Ophthalmol. 2015; 94(1):10-20.

PMID: 26036605 PMC: 4744664. DOI: 10.1111/aos.12758.

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