The Impact of Successful Cataract Surgery on Quality of Life, Household Income and Social Status in South India

Abstract

BackgroundTo explore the hypothesis that sight restoring cataract surgery provided to impoverished rural communities will improve not only visual acuity and vision-related quality of life (VRQoL) but also poverty and social status.MethodsParticipants were recruited at outreach camps in Tamil Nadu, South India, and underwent free routine manual small incision cataract surgery (SICS) with intra-ocular lens (IOL) implantation, and were followed up one year later. Poverty was measured as monthly household income, being engaged in income generating activities and number of working household members. Social status was measured as rates of re-marriage amongst widowed participants. VRQoL was measured using the IND-VFQ-33. Associations were explored using logistic regression (SPSS 19).ResultsOf the 294 participants, mean age ± standard deviation (SD) 60±8 years, 54% men, only 11% remained vision impaired at follow up (67% at baseline; p<0.001). At one year, more participants were engaged in income generating activities (44.7% to 77.7%; p<0.001) and the proportion of households with a monthly income <1000 Rps. decreased from 50.5% to 20.5% (p<0.05). Overall VRQoL improved (p<0.001). Participants who had successful cataract surgery were less likely to remain in the lower categories of monthly household income (OR 0.05–0.22; p<0.02) and more likely to be engaged in income earning activities one year after surgery (OR 3.28; p = 0.006). Participants widowed at baseline who had successful cataract surgery were less likely to remain widowed at one year (OR 0.02; p = 0.008).ConclusionThese findings indicate the broad positive impact of sight restoring cataract surgery on the recipients’ as well as their families’ lives. Providing free high quality cataract surgery to marginalized rural communities will not only alleviate avoidable blindness but also - to some extent - poverty in the long run.

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.…”

Optimizing Outcome of Cataract Surgery in Resource Scarce Sub-Saharan Africa

“…Suffice it to say that sight is restored almost immediately thus improving the patients' quality of life [19,20]. This observation may result in considering the procedure so casually without taking meticulous steps that ensure that there is quality in terms of postoperative visual acuity and patient's safety.…”

Interventions to improve the labour market for adults living with physical and/or sensory disabilities in low- and middle-income countries: a systematic review

“…• India (Biggeri et al, 2012;Finger et al, 2012;Gershon & Srinivasan, 1992;Shore & Juillerat, 2012); • Nigeria (Eniola & Adebiyi, 2007); • Philippines (Lagerkvist, 1992b); • Vietnam (Shore & Juillerat, 2012).…”

“…There was variation in sample sizes. One study had a sample size greater than 500 participants (Shore & Juillerat, 2012), the sample size was between 251 and 500 in three studies (Biggeri et al, 2012;Finger et al, 2012;Nuri et al, 2012), and the remaining ten studies had a sample size of less than 250. All studies designated the individual/household as the unit of analysis.…”

“…Two impact assessments focused exclusively on people with sensory disabilities (Eniola & Adebiyi, 2007;Finger et al, 2012). The study samples of the remaining four evaluations included participants with any/multiple types of disability, predominantly those with physical and sensory impairments (Biggeri et al, 2012;Lagerkvist, 1992a;Lagerkvist, 1992b;Nuri et al, 2012).…”