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November 1994

Improved Visual Function and Attenuation of Declines in Health-Related Quality of Life After Cataract Extraction

Author Affiliations

From the Divisions of Clinical Epidemiology (Drs Mangione, Orav, and Goldman) and General Medicine, Department of Medicine, Brigham and Women's Hospital; the Division of Clinical Epidemiology, Beth Israel Hospital (Drs Phillips and Goldman); and the Epidemiology Unit (Dr Seddon) and Cataract Consultation Service (Dr Lawrence) and General Eye Service (Dr Lawrence), Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School; and the Department of Biostatistics, Harvard School of Public Health (Dr Orav), Boston, Mass. Dr Mangione is now with UCLA Medical School, Los Angeles, Calif.

Arch Ophthalmol. 1994;112(11):1419-1425. doi:10.1001/archopht.1994.01090230033017

Objective:  To measure the effect of cataract extraction and lens implantation on elderly persons' health-related quality of life and on their ability to perform visual activities.

Design:  Evaluations of health status were conducted preoperatively and at 3 and 12 months after surgery on patients scheduled for cataract extraction.

Setting:  Patients were enrolled from the General Eye Service of the Massachusetts Eye and Ear Infirmary and 33 Boston practices.

Patients:  The cohort consisted of 464 patients aged 65 years or older who were identified from the surgical schedule of the Massachusetts Eye and Ear Infirmary. At 3 to 12 months after surgery, 458 (99%) of the participants were successfully contacted. Health-related quality of life data were available for 419 (90%) to assess changes after surgery.

Main Outcome Measures:  Ophthalmologic examinations were performed preoperatively and during the follow-up period. The Activities of Daily Vision Scale (ADVS) and the Medical Outcomes Study 36-item short form (SF-36) were administered before surgery and at 3 and 12 months postoperatively to assess changes in health status.

Results:  At 12 months after surgery, 95% of patients had improved Snellen visual acuity, 80% had improved ADVS scores, but only 36% had improved SF-36 physical functioning. Average scores on seven of eight SF-36 sub-scales worsened at 12 months. Patients with improved ADVS scores had significantly smaller declines across all SF-36 dimensions except for role limitations due to emotional problems.

Conclusion:  Improved visual function after cataract surgery was associated with better health-related quality of life, suggesting that age-related declines in health may be attenuated by improvements in visual function.

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