Second-Eye Cataract Surgery, Vision, and Quality of Life
Ophthalmology, October 2017
Second-eye cataract surgery is common in developed countries and is expected to grow in popularity, despite reports indicating that its benefits may be inferior to those of first-eye surgery. Shekhawat et al. determined that visual function and quality of life (QOL) improve substantially after surgery on the second eye.
For this multicenter study, the researchers included 328 patients (mean age, 70.4 years) who underwent separate first- and second-eye cataract surgeries in the United States. Comprehensive ophthalmic exams were performed pre- and postoperatively for both procedures. Best-corrected visual acuity (BCVA) was measured and patients completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) 30-90 days pre- and postoperatively. NEI-VFQ scores were calculated using a traditional subscale scoring algorithm and the Rasch-refined approach, each yielding separate data for socioemotional impact (QOL) and visual function. Primary outcome measures were postoperative NEI-VFQ scores and the differences between these scores for the 2 procedures.
Relative to the second eyes, first eyes had poorer mean preoperative BCVA (0.55 vs. 0.36 logMAR), greater improvement in mean BCVA after surgery (–0.50 vs. –0.32 logMAR), and slightly worse postoperative BCVA (0.06 vs. 0.03 logMAR). Second-eye surgery resulted in higher postoperative NEI-VFQ scores for nearly all traditional subscales and for the visual function and socioemotional subscales (visual function, –3.85 vs. –2.91 logits; socioeconomic, –2.63 vs. –2.10 logits).
The authors concluded that, in general, second-eye cataract surgery appears more beneficial than first-eye surgery, especially with respect to QOL. They recommend that, during consultation for potential surgery on the second eye, patients be asked about their current level of satisfaction with visual function and QOL.
The original article can be found here.