Cataract surgery and changes in quality of life measures.

Background: This study examines whether quality of life measured with non-disease specific instruments is altered by cataract surgery and whether the effect is modulated by the presence of ocular comorbidity or other non-ocular issues.

Methods: Thirteen patients were assessed pre- and at three months post-cataract surgery. Visual disability was measured with the Visual Disability Assessment. Quality of life was measured using two established generic instruments: the Cantril Ladder and the Profile of Mood States (POMS). Subjects were also asked to report any events that may have influenced their quality of life in the three months after surgery.

Results: Visual acuity and visual disability were significantly improved by surgery (p < 0.01). Cantril Ladder score was significantly improved after surgery (p = 0.04). The POMS score improved significantly after surgery, only when cases with ocular comorbidity were excluded (p = 0.04). Two cases had a large deterioration in POMS score that was attributable in one case, to the death of a partner and in the other (a patient with severe glaucoma) to depression from the realisation that there was no further potential for visual improvement.

Discussion: Quality of life can be measurably improved by cataract surgery. However, this is less likely if ocular comorbidity is present. The use of generic instruments for outcome studies increases the likely influence of external factors on quality of life measures. Disease specific instruments, such as the Visual Disability Assessment, should be used wherever possible in outcomes research.