[Influence of cataract and intraocular lens surgery on health-related quality of life].

Purpose: To evaluate the vision-related quality of life(QOL) in patients undergoing cataract surgery with the Japanese version of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25).

Subjects And Methods: Subjects were 110 patients [70.4 +/- 9.2 (mean +/- standard deviation) years old] undergoing bilateral cataract surgery. Best-corrected visual acuity was 20/30 or worse in both eyes. The VFQ-25 was recorded before and 2 months after phacoemulsification and foldable intraocular lens implantation, and the influence of various clinical parameters was assessed. The VFQ-25 was also recorded in 69 glaucoma patients with visual field defects in both eyes, and in 31 normal subjects.

Results: The VFQ-25 scores before cataract surgery were as low as the scores obtained in glaucoma patients. Cataract surgery significantly improved VFQ-25 scores to the level of normal subjects Statistically significant improvements were observed in subscales such as general vision, near activities, distance activities, driving, peripheral vision, color vision, social functioning, dependency, role difficulties, mental health, and total score (p<0.001, paired t-test). The degree of improvement in VFQ-25 scores did not correlate with preoperative or postoperative visual acuity, uncorrected or corrected. The VFQ-25 scores improved more in younger patients, and improvement in the general vision subscale showed a significant negative correlation with age (r= -0.286, p=0.009, Pearson correlation coefficient). The degree of posterior subcapsular cataract in better eyes showed significant correlation with the improvement in subscales, such as distance activity (r =0.413, p<0.001), driving (r= 0.449, p=0.015), social functioning (r=0.308, p= 0.004), mental health (r=0.330, p=0.002), dependency (r=0.323, p=0.003), and total score (r=0.328, p=0.002). Other types of cataract had no correlation. Men tended to show more improvement in VFQ-25 scores by surgery than women, except for the dependency subscale.

Conclusion: The current study quantitatively demonstrated that vision-related QOL is significantly impaired in patients with cataract, and that cataract surgery dramatically improves patients' QOL.