Korean J Prev Med.
2001 May;34(2):175-181.
Time Series Observations of Outcome Variables and the Factors Associated
with the Improvement in the Patient Outcomes of Cataract Surgery
- Affiliations
-
- 1Department of Preventive Medicine and Public Health, College of Medicine, Yonsei
University; Graduate School of Health Science and Management, Yonsei University.
Abstract
OBJECTIVES
To compare the multiple outcomes of patients with cataract surgery at
perioperative time, 3-4 months and 12 months after surgery and to assess patient
outcomes associated with visual improvement(visual acuity of operated eye, visual
function-14(VF-14), symptom score).
METHODS
For this assessment, a prospective study was conducted with 389 patients
who had undergone cataract surgery for either one eye or both eyes. The surgery was
performed by 20 ophthalmologists who were practicing at university hospitals and
general hospitals. Patients were interviewed and clinical data were obtained. Doctors
were questioned with self-reported questionnaire forms. Medical records were examined
in order to measure variables related to the surgical process such as surgical methods
and ocular comorbidity. The survey was conducted at 4 stages : preoperative
time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343
cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases
with incomplete data, 198 cases were enrolled in the study. Patient outcomes was
measured for any improvement in the functional outcomes(visual acuity of operated eye,
visual function, symptom score) at postoperative 3-4 months.
RESULTS
The visual acuity(operated, weighted average), symptom score, VF-14 score,
satisfaction with vision, and subjective health status were shown to be improved at the
perioperative time, postoperative 3-4 months and 12 months. An improvement in the
Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements
of the VF-14 score and cataract symptom score were observed in 151 patients(76.3%)
and 179 patients(90.4%), respectively. All three outcome measures demonstrated
improvement in 137 patients(69.2%).
The improvement of the three functional outcomes at 3-4 months after receiving
surgery was associated with a lower level of visual function and a higher level of
cataract symptom score at perioperative time, as well as a greater experience level of
the surgeon.
CONCLUSIONS
In this study, the estimates of the proportion of patients benefiting from
cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score,
a measure of functional impairment related to vision, and symptom score may be better
measures of the benefit derived from cataract surgery than the change in visual acuity.