Visual Acuity, Quality of Life and Visual Function Outcomes after Cataract Surgery in Bali.
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PURPOSE: To assess post-cataract surgery intermediate-term (>6 months) data of visual acuity (VA), surgical complications, refractive outcomes, quality of life (QOL) and visual function (VF) from a non-governmental organization program in Indonesia. METHODS: Retrospective cohort study design. Participants were a selection of patients who underwent cataract surgery by the John Fawcett Foundation between 2006 and 2011, with at least 6 months follow-up. Patients underwent comprehensive ophthalmic examinations. QOL and VF questionnaires were administered. RESULTS: From a total of 1557 invited to attend, 547 patients participated; 99.8% of eyes had presenting VA <6/60. At day 1 postoperatively, 52.1% of patients had a good outcome by World Health Organization criteria (unaided VA6/18). Six months or later postoperatively, 85% of eyes had best-corrected VA6/18 and 5.6% of eyes had best-corrected VA<3/60. At final follow-up, mean postoperative spherical equivalent refraction was -2.35 diopters (standard deviation 1.75, n=542). On a scale of 1-100, median converted values for QOL were 25.0 preoperatively and 74.0 postoperatively, a statistically significant improvement (p<0.001). Of eyes with VA better than 3/60 on postoperative day 1, 5.7% (95% confidence interval 3.6-7.9%) became blind (VA<3/60) at the 6-month or later time point. CONCLUSION: Cataract surgery in this population markedly improved QOL, despite a trend towards myopic refractive outcomes. These findings raise questions about biometric methodology, intraocular lens power calculations and refractive targets. Postoperative day 1 VA data may be a reasonable proxy of the intermediate-term rate of non-blind eyes.
author list (cited authors)
Farmer, L., Innes-Wong, C., Bergman-Hart, C., Casson, R. J., & Crompton, J.
complete list of authors
Farmer, Lachlan||Innes-Wong, Cecilia||Bergman-Hart, Caroline||Casson, Robert J||Crompton, John