Impact of cataract surgery on health-related quality of life in nursing home residents

Abstract

Aim: To assess the impact of cataract surgery in nursing home residents on health-related quality of life, as compared to those who have cataracts but who do not undergo surgery. Methods: A prospective cohort study enrolled 30 nursing home residents (>60 years old) who had cataracts and underwent cataract surgery, and evaluated vision-targeted and generic health-related quality of life and depressive symptoms before and approximately 4 months after surgery. This cataract surgery group was compared to 15 nursing home residents who had cataracts but who did not have surgery, over the same timeframe. Results: Visual acuity for near and distance and contrast sensitivity improved following cataract surgery (p,0.001). Adjusting for age differences in the two groups, the cataract surgery group exhibited significant score improvement in the general vision (p = 0.005), reading (p = 0.001), psychological distress (p = 0.015), and social interaction (p = 0.033) subscales of the Nursing Home Vision-targeted Health-Related Quality of Life Questionnaire and the VF-14 (p = 0.004). There were no group differences in the SF-36, Geriatric Depression Scale or the Cataract Symptom Score. Conclusion: Nursing home residents who underwent cataract surgery because of functional problems experienced significant improvements in their vision-targeted health-related quality of life, in addition to dramatically improved vision. N ursing home residents in the USA and other industrialised countries have high rates of vision impairment with estimates ranging from 3 to 15 times higher than corresponding rates for community-dwelling older adults.

Impact of cataract surgery on vision-related life performances: the usefulness of Real-Life Vision Test for cataract surgery outcomes evaluation

“…Cataract patients experienced decreased depressive symptoms and significant improvements in the vision-targeted quality of life after surgery. Similar with other studies, 6,7,11,12,32 patients in our study reported improved general vision, less difficulty with daily life activities and greater likelihood of engaging in social interactions following cataract surgery. Meanwhile, in comparing the changes from baseline to follow-up, cataract patients exhibited significant improvements in the RLVT.…”

“…Similar with the previous study, 7 our data revealed significant associations between improvements of RLVT and changes of clinical measures [18][19][20][21] and less susceptible to confounding factors. 23,35 All these results of current study contribute to the validity of the RLVT as a potential assessment for cataract surgery outcomes.…”

“…[6][7][8][9][10][11][12] Improvements in visual function and self-report questionnaires after cataract surgery have been wildly confirmed. [6][7][8][9][10][11][12] The benefit of cataract surgery, however, on vision-related ability of daily living in the elderly has not yet been investigated systemically.…”

“…Indeed, vision-related quality of life is the issue of greatest importance to many cataract patients, and many lines of evidence suggest that cataract not only destroy visual function but also affect activities of daily life in many ways. [3][4][5][6][7] It is possible that cataract surgery-induced improvements should be translated by considerable gains in patients' daily life performances and social life components.…”

A prospective study of the bi-directional association between vision loss and depression in the elderly

“…Owsley et al showed, for example, that immediate refractive error correction reduced depression in comparison with delayed correction (Owsley et al, 2007a). However, in the same population, cataract surgery did not appear to have a similar effect (Owsley et al, 2007b). Age-related macular degeneration has also previously been demonstrated to be associated with high rates of depression, anxiety and emotional distress (Berman and Brodaty, 2006) and in a randomized controlled clinical trial that compared the efficacy of problem-solving treatment with usual care in patients, treatment of depression was found to be effective in the short-term but the benefits were not maintained over time (Rovner et al, 2007).…”