Determinants of patient satisfaction and function related to vision following cataract surgery in eyes with no visually consequential ocular co-morbidity

• Published in: Graefe's archive for clinical and experimental ophthalmology 2015-10, Vol.253 (10), p.1735-1744
• Main Authors: Kirwan, Clare, Nolan, John M., Stack, Jim, Moore, Tara C. B., Beatty, Stephen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cataract; Cataract - physiopathology; Comorbidity; Eyeglasses; Female; Humans; Lens Implantation, Intraocular; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Patient Satisfaction - statistics & numerical data; Phacoemulsification; Pseudophakia - physiopathology; Sensory Thresholds; Surveys and Questionnaires; Vision Disorders - physiopathology; Vision Disorders - therapy; Visual Acuity - physiology; Young Adult
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-015-3038-7

Purpose To investigate subjectively reported outcomes following cataract surgery and the relationships between such outcomes in the context of falling thresholds for cataract surgery. Setting Large, private, non-refractive cataract practice, Institute of Eye Surgery, Whitfield Clinic, Waterford, Ireland Methods Pre-operative, intra-operative and post-operative data of 2552 eyes undergoing phacoemulsification and implantation of the Tecnis R ZCB00 1-piece intraocular lens (IOL) by a single surgeon between July 2009 and October 2013 was analysed. Patients without visually consequential ocular co-morbidity completed two validated questionnaires, designed to assess subjectively perceived visual functioning and identify symptoms of dysphotopsia following cataract surgery. Results 54.8 % of questionnaire respondents were entirely satisfied (satisfaction 10/10) post-operatively, with 83.7 % reporting satisfaction of ≥7/10. Satisfaction was positively associated with patient age and negatively associated with spectacle dependence, dysphotopsia, and function related to vision (NEI VF-11) score. The mean (±standard deviation[SD]) dysphotopsia score was 1.36 (±1.9; scale 0–10), with 40 % of respondents reporting no dysphotopsia symptoms and 9.8 % reporting clinically meaningful dysphotopsia. The mean (±SD) National Eye Institute visual function-11 (NEI VF-11) score was 0.33 (±0.53; scale 0–4) and reduced function related to vision was associated with increasing severity of dysphotopsia symptoms. When linear regression was applied, 17.5 % of the variation in functionality was attributable to symptoms of dysphotopsia. Conclusion Dysphotopsia is an important determinant of a patient having difficulty with vision-related tasks following cataract surgery, and patient satisfaction is positively associated with patient age and negatively associated with spectacle in dependence, dysphotopsia and function related to the vision (NEI VF-11) score.