Impact of cataract surgery on vision-related life performances: the usefulness of Real-Life Vision Test for cataract surgery outcomes evaluation

Abstract

Purpose Real-Life Vision Test (RLVT) is a newly developed performance-based measures of functional vision. This present study is designed to determine whether it could be a meaningful assessment for cataract surgery outcomes evaluation. Patients and methods Age-related cataract patients (56) who scheduled for bilateral cataract surgery and 44 age-matched controls were evaluated by four types of measurements: (1) demographic, medical, cognitive and depressive evaluation, and the reaction time testing; (2) clinical measures (visual acuity, contrast sensitivity, stereopsis, and color perception); (3) the 25-item National Eye Institute's Visual Functioning Questionnaire (NEI-VFQ); (4) the RLVT. Spearman's coefficients and multiple regression analysis were conducted to investigate the relationship among RLVT, clinical measures, and self-report assessment of visual function. Results The results of RLVT, clinical measures, and NEI-VFQ total scores were improved significantly after cataract surgery. There were no differences between control subjects and post-surgery patients with respect to NEI-VFQ-25 total scores, self-rating depression scale scores and three tasks of RLVT. Change of RLVT was significantly associated with the change of clinical measures in the cataract group. Multiple regression analysis demonstrated that change of distance, intermediate, and near visual acuity, and binocular contrast sensitivity were significant predictors of improvements of RLVT.Conclusions Cataract surgery could improve real-world visual ability effectively for cataract patients. Our study highlights the potential usefulness of RLVT as an adjunct to the current outcomes evaluation system for cataract surgery. The use of RLVT combined with clinical and self-survey methods may be the comprehensive strategy to manifest the impact of cataract surgery on patients' overall vision-related quality of life.

Deterioration of contrast sensitivity in eyes with epiphora due to lacrimal passage obstruction

“…Contrast sensitivity, which is related to the deterioration in the quality of vision, is reduced in various ocular diseases, such as cataract [18,19], glaucoma [20], vitreous floaters [21], agerelated macular degeneration [20,22], and neuromyelitis optica spectrum disorders [23], and also in refractive abnormalities such as LASIK intervention [24,25], myopia [26], and multifocal contact lenses [27,28]. How well a patient sees at the higher spatial frequency channels, which is well captured by conventional measures of visual acuity, does not necessarily predict vision at middle and lower frequencies [29].…”

“…Since a decline in VA is rarely detected in patients with epiphora caused by lacrimal passage obstruction, it is crucial to assess contrast sensitivity function to understand the link between the symptoms and their impact on the quality of life. Moreover, activities related to the quality of life, including driving [19,30], mobility, walking speed [31,32], reading speed [33,34], and computer task accuracy [35] are reportedly associated with contrast sensitivity. Patients with epiphora often have difficulties in driving, descending stairs, reading books, or text on computer monitors, which might be affected by deterioration of contrast sensitivity.…”

Impact of cataract surgery on depression and cognitive function: Systematic review and meta‐analysis

“…Finally, 16 articles that met the inclusion criteria were included in the meta‐analysis (Table S1). 22‐37 …”

Correlation among Lens Opacities Classification System III grading, the 25-item National Eye Institute Visual Functioning Questionnaire, and Visual Function Index-14 for age-related cataract assessment

“…Agerelated cataract is the most common type of cataract that injuries the visual function and quality of life for the elderly [1,2]. Cataract surgery can significantly improve vision, visual functioning, and the quality of life of patients [3][4][5][6][7]. Therefore, it is essential to determine the surgical timing for cataract.…”

“…Therefore, it is essential to determine the surgical timing for cataract. In order to comprehensively assess the status of patients with cataract, objective and subjective measures were performed and studied [6,[8][9][10].…”