Posters

Changes in quality of life shortly after first and second eye cataract surgery assessed using a non-procedure specific patient-reported outcome measure

Poster Details

First Author: S.Heemraz UK

Co Author(s):    C. Lee   C. Hammond   O. Mahroo        

Abstract Details

Purpose:

Cataract surgery outcomes are commonly assessed in terms of post-operative visual acuity and refractive error, but the importance of patient-perceived changes in quality of life should not be overlooked. In addition, quality of life assessment tools that are not procedure specific can enable comparison with other interventions, potentially in other specialties, which can be important in planning resource allocation. The Glasgow Benefit Inventory (GBI) is a non-procedure specific, post-interventional, quality of life questionnaire, which was originally used in otolaryngological procedures, but which has since also been used in ophthalmology. We administered the GBI to cataract patients following surgery to (1) quantify changes in quality of life, (2) compare changes in quality of life between patients who underwent first and second eye surgery, (3) compare with outcomes following other procedures, and (4) to provide baseline data to enable future comparisons with patient-reported quality of life outcomes in different cataract groups or at different post-operative time points.

Setting:

A weekly nurse-led post-operative cataract clinic in a large ophthalmology department. Patients undergoing uncomplicated cataract surgery are followed up in this clinic typically 2-4 weeks post-surgery.

Methods:

The GBI consists of 18 questions relating to changes in quality of life, each answered on a five point Likert scale. It yields a total score, as well as sub-scores relating to general, physical health and social support sub-domains. Scores range from +100 (maximum benefit) to -100 (maximum detriment); a score of zero indicates no change. The questionnaire was administered to consecutive patients seen in the nurse-led clinic over a four month period.

Results:

The GBI was administered 119 times to 114 patients (5 patients were seen following both first and second eye surgery during the time period of the study). Mean patient age (SD) was 70 (11) years. Mean overall score was +22.7 (SD 19.6, 95% CI +19.1 to +26.3). Mean (SD) sub-scores were +30.4 (25.3), +17.1 (26.7) and -2.7 (20.5) for general, social support and physical health sub-domains respectively. In almost all cases a negative physical health score was simply due to having to use eye drops post-operatively (which scores as 'extra medication' in this domain). Sixty-six patients were surveyed following first eye cataract surgery, and 53 following second eye surgery. Mean overall scores were +21.5 (SD 18.1, 95% CI +17.1 to +26.0) and +24.2 (SD 21.5, 95% CI +18.2 to +30.1)) following first and second eye surgery respectively. There were no significant differences between the two groups for any of the scores or subscores (p > 0.35 for all comparisons, unpaired t test).

Conclusions:

Our study confirmed that patients had positive changes in quality life following cataract surgery as assessed with a non-procedure specific patient reported outcome measure, administered only a few weeks post-surgery (mean GBI score +22.7, 95% CI +19.1 to +26.3). Also, statistically significant improvements in quality of life were noted after both first eye and second eye surgery. No significant differences in scores were seen when comparing first eye or second eye surgery. The mean score was in the same range as that found in a recent study of four oculoplastic procedures (+17.7 to +32.3). Future studies can compare specifically between cataract groups and can also explore whether patient-perceived improvement in quality of life is sustained at later time points post-operatively. FINANCIAL INTEREST: NONE