Evaluation of post-operative visual function and quality of life outcomes following phacoemulsification: a hospital based study in Bangladesh

Session Details

Session Title: Cataract Surgery Outcomes and Practice Styles

Session Date/Time: Wednesday 09/09/2015 | 08:00-09:30

Paper Time: 08:12

Venue: Room 17

First Author: : N.Ferdausi BANGLADESH

Co Author(s): :    A. Hussain   J. Ahmed                 

Abstract Details

Purpose:

The goal of cataracts surgery is to improve visual acuity and therefore the visual function (VF), considering that it entails improvements in quality of life (QoL). A patient's recognition of satisfaction with improvement in VF is the ultimate indicator of the effectiveness of intervention. The evaluation of cataract surgery outcome not only depends on postoperative visual acuity but also on patient's perceived satisfaction, independence and daily activities. The purpose of this hospital based study was to assess the patients' overall VF and QoL after phacoemulsification with posterior capsular intraocular lens implantation.

Setting:

This study was conducted in National Institute of Ophthalmology and Hospital (NIO&H), Dhaka, Bangladesh. This is the only public apex eye hospital in the country providing specialized eye care services for self-reported and referred patients.

Methods:

This was a hospital based prospective study during the period of July 2013 to March 2014. Two hundred and eighty patients with bilateral cataract were recruited in this study. Exclusion criteria were patients with psychiatric disorders, complicated cataract, glaucoma, known case of diabetic retinopathy, corneal disorders, or previous eye surgery in either eye. Patients were intervened with lens phacoemulsification and posterior capsular IOL implantation. 169 patients completed the final 3 months post-operative follow-up. WHO/PBD-VF20 and EQ-5D questionnaire were administered before intervention of 1st eye and after 3-months intervention of 2nd eye to assess patients' visual function and quality of life.

Results:

The mean age of the patients was 64.6 ± 6.7 years and male-female ratio was 1.5:1. Post-operatively patients had significantly better mean visual function score than pre-operative stage (p =0.000). Post-operatively there was a positive correlation between visual acuity and visual function (r =0.5, p < 0.001). Preoperatively patients were significantly more likely to report poorer mean mobility, self-care, usual activity, anxiety and self-rated health and as a result of poor quality of life (p=0.000). Post-operatively there was positive correlation between visual acuity and quality of life (r =0.8, p < 0.001). Post-operatively patients had significantly higher mean self-rated health.

Conclusions:

This study has shown a significant improvement in visual acuity, visual function and quality of life following phacoemulsification with posterior capsular intraocular lens implantation. Phacoemulsification with posterior capsular IOL implantation is an effective and safe method for improving quality of life of cataract patient. In developing countries like Bangladesh more young ophthalmologists need access to training on phacoemulsification. Advocacy should be done at policy level for appropriate strategies to increase training facilities and thus improving the cataract patients' quality of life.

Financial Interest:

NONE