Patient reported outcomes of surgery for senile cataract in two hospitals in North-central, Nigeria

Abstract

Background: Cataract surgery is an efficient, cost-effective health intervention that is intended to not only restore vision, but to also improve patients’ visual function (VF) and quality of life (QoL). The World Health Organization’s approach to monitoring outcomes of cataract surgery is a combination of clinical and patient reported outcomes (PROs) evaluation. This study assessed VF and QoL post cataract surgery and their relationship with post- operative presenting visual acuity (PPVA) in patients operated for senile cataract in two hospitals in Jos, North-central Nigeria. Methodology: A retrospective, hospital-based, cross-sectional survey of patients aged 40 years and above, operated for senile cataract who were six weeks or more post-surgery. Eligible patients who gave informed consent were consecutively enrolled. Sociodemographic data and surgical history were obtained from the patients and from their surgical records. A trained research assistant administered the VF-14 item and QoL-12 item questionnaires and responses scored using Fletcher’s guidelines. The PPVA was assessed using Snellen’s acuity and converted to LogMAR scale. Data was analysed with STATA version 16.0 using geometric mean, range, percentages and Spearman’s rank test. Results: Eighty-seven participants aged 40 to 104 years with a male to female ratio of 1.1:1 were enrolled. Their median PPVA was 0.6LogMAR (inter-quartile range = -0.15 to +2.9). The geometric mean of total VF and QoL were 87.1% and 97.5% respectively. Depth perception (99.6%), visual perception and peripheral vision (94.2% each) were the highest subscales in VF. Self-care in the QoL sub-domain scored 100% while mental wellbeing and social interaction scored 97.9% and 97.3% respectively. The PPVA negatively correlated with mean total VF (rs = -0.4, P<0.0001) and mean total QoL (rs = -0.3, P = 0.011) Conclusion: The total VF and QoL scores and across all subscales of the study population were high and improved with rising PPVA. Keywords: Visual function, quality of life, cataract surgery Key message: The use of patient reported outcome measures alongside clinical outcome evaluation provides a holistic assessment of the full benefits of cataract surgery.