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Impact of First Eye versus Second Eye Cataract Surgery on Visual Function and Quality of Life.
Ophthalmology. 2017 10; 124(10):1496-1503.O

Abstract

PURPOSE

To compare the impact of first eye versus second eye cataract surgery on visual function and quality of life.

DESIGN

Cohort study.

PARTICIPANTS

A total of 328 patients undergoing separate first eye and second eye phacoemulsification cataract surgeries at 5 veterans affairs centers in the United States. Patients with previous ocular surgery, postoperative endophthalmitis, postoperative retinal detachment, reoperation within 30 days, dementia, anxiety disorder, hearing difficulty, or history of drug abuse were excluded.

METHODS

Patients received complete preoperative and postoperative ophthalmic examinations for first eye and second eye cataract surgeries. Best-corrected visual acuity (BCVA) was measured 30 to 90 days preoperatively and postoperatively. Patients completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) 30 to 90 days preoperatively and postoperatively. The NEI-VFQ scores were calculated using a traditional subscale scoring algorithm and a Rasch-refined approach producing visual function and socioemotional subscale scores.

MAIN OUTCOME MEASURES

Postoperative NEI-VFQ scores and improvement in NEI-VFQ scores comparing first eye versus second eye cataract surgery.

RESULTS

Mean age was 70.4 years (±9.6 standard deviation [SD]). Compared with second eyes, first eyes had worse mean preoperative BCVA (0.55 vs. 0.36 logarithm of the minimum angle of resolution (logMAR), P < 0.001), greater mean BCVA improvement after surgery (-0.50 vs. -0.32 logMAR, P < 0.001), and slightly worse postoperative BCVA (0.06 vs. 0.03 logMAR, P = 0.039). Compared with first eye surgery, second eye surgery resulted in higher postoperative NEI-VFQ scores for nearly all traditional subscales (P < 0.001), visual function subscale (-3.85 vs. -2.91 logits, P < 0.001), and socioemotional subscale (-2.63 vs. -2.10 logits, P < 0.001). First eye surgery improved visual function scores more than second eye surgery (-2.99 vs. -2.67 logits, P = 0.021), but both first and second eye surgeries resulted in similar improvements in socioemotional scores (-1.62 vs. -1.51 logits, P = 0.255).

CONCLUSIONS

Second eye cataract surgery improves visual function and quality of life well beyond levels achieved after first eye cataract surgery alone. For certain socioemotional aspects of quality of life, second eye cataract surgery results in comparable improvement to first eye cataract surgery.

Authors+Show Affiliations

VA Tennessee Valley Healthcare System, Nashville, Tennessee; Vanderbilt University School of Medicine, Nashville, Tennessee; W.K. Kellogg Eye Center, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: nakul.shekhawat@vanderbilt.edu.St. Louis VA Medical Center, St. Louis, Missouri; Washington University School of Medicine, St. Louis, Missouri.Michael E. DeBakey VA Medical Center, Houston, Texas; Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.VA Boston Healthcare System, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.St. Louis VA Medical Center, St. Louis, Missouri; Washington University School of Medicine, St. Louis, Missouri.Department of Defense/VA Vision Center of Excellence, Arlington, Virginia.VA Tennessee Valley Healthcare System, Nashville, Tennessee; Vanderbilt University School of Medicine, Nashville, Tennessee.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

28526550

Citation

Shekhawat, Nakul S., et al. "Impact of First Eye Versus Second Eye Cataract Surgery On Visual Function and Quality of Life." Ophthalmology, vol. 124, no. 10, 2017, pp. 1496-1503.
Shekhawat NS, Stock MV, Baze EF, et al. Impact of First Eye versus Second Eye Cataract Surgery on Visual Function and Quality of Life. Ophthalmology. 2017;124(10):1496-1503.
Shekhawat, N. S., Stock, M. V., Baze, E. F., Daly, M. K., Vollman, D. E., Lawrence, M. G., & Chomsky, A. S. (2017). Impact of First Eye versus Second Eye Cataract Surgery on Visual Function and Quality of Life. Ophthalmology, 124(10), 1496-1503. https://doi.org/10.1016/j.ophtha.2017.04.014
Shekhawat NS, et al. Impact of First Eye Versus Second Eye Cataract Surgery On Visual Function and Quality of Life. Ophthalmology. 2017;124(10):1496-1503. PubMed PMID: 28526550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of First Eye versus Second Eye Cataract Surgery on Visual Function and Quality of Life. AU - Shekhawat,Nakul S, AU - Stock,Michael V, AU - Baze,Elizabeth F, AU - Daly,Mary K, AU - Vollman,David E, AU - Lawrence,Mary G, AU - Chomsky,Amy S, Y1 - 2017/05/16/ PY - 2016/08/07/received PY - 2017/04/12/revised PY - 2017/04/13/accepted PY - 2017/5/21/pubmed PY - 2017/9/30/medline PY - 2017/5/21/entrez SP - 1496 EP - 1503 JF - Ophthalmology JO - Ophthalmology VL - 124 IS - 10 N2 - PURPOSE: To compare the impact of first eye versus second eye cataract surgery on visual function and quality of life. DESIGN: Cohort study. PARTICIPANTS: A total of 328 patients undergoing separate first eye and second eye phacoemulsification cataract surgeries at 5 veterans affairs centers in the United States. Patients with previous ocular surgery, postoperative endophthalmitis, postoperative retinal detachment, reoperation within 30 days, dementia, anxiety disorder, hearing difficulty, or history of drug abuse were excluded. METHODS: Patients received complete preoperative and postoperative ophthalmic examinations for first eye and second eye cataract surgeries. Best-corrected visual acuity (BCVA) was measured 30 to 90 days preoperatively and postoperatively. Patients completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ) 30 to 90 days preoperatively and postoperatively. The NEI-VFQ scores were calculated using a traditional subscale scoring algorithm and a Rasch-refined approach producing visual function and socioemotional subscale scores. MAIN OUTCOME MEASURES: Postoperative NEI-VFQ scores and improvement in NEI-VFQ scores comparing first eye versus second eye cataract surgery. RESULTS: Mean age was 70.4 years (±9.6 standard deviation [SD]). Compared with second eyes, first eyes had worse mean preoperative BCVA (0.55 vs. 0.36 logarithm of the minimum angle of resolution (logMAR), P < 0.001), greater mean BCVA improvement after surgery (-0.50 vs. -0.32 logMAR, P < 0.001), and slightly worse postoperative BCVA (0.06 vs. 0.03 logMAR, P = 0.039). Compared with first eye surgery, second eye surgery resulted in higher postoperative NEI-VFQ scores for nearly all traditional subscales (P < 0.001), visual function subscale (-3.85 vs. -2.91 logits, P < 0.001), and socioemotional subscale (-2.63 vs. -2.10 logits, P < 0.001). First eye surgery improved visual function scores more than second eye surgery (-2.99 vs. -2.67 logits, P = 0.021), but both first and second eye surgeries resulted in similar improvements in socioemotional scores (-1.62 vs. -1.51 logits, P = 0.255). CONCLUSIONS: Second eye cataract surgery improves visual function and quality of life well beyond levels achieved after first eye cataract surgery alone. For certain socioemotional aspects of quality of life, second eye cataract surgery results in comparable improvement to first eye cataract surgery. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/28526550/Impact_of_First_Eye_versus_Second_Eye_Cataract_Surgery_on_Visual_Function_and_Quality_of_Life_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(16)30787-4 DB - PRIME DP - Unbound Medicine ER -