Evaluation of quality of life in patients with cataract in Hong Kong.

ABSTRACT

PURPOSE: To evaluate the quality of life in patients in a public hospital in Hong Kong before and after cataract surgery using a new questionnaire. SETTING: Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong, China. METHODS: One hundred ten Chinese patients having cataract extraction were evaluated for surgical outcomes and quality of life using a questionnaire modified to reflect the local culture and environment in Hong Kong. The questionnaire consisted of 20 questions divided into 4 domains distance vision, near vision, social function, and cataract-related symptoms. The test-retest reliability of the questionnaire was assessed in another 15 patients by weighted kappa and internal consistency tested with the Cronbach alpha. Construct validity was tested by correlating visual acuity with quality of life and subjective visual improvement and satisfaction with quality-of-life improvement. The preoperative and 4-month postoperative quality of life were evaluated, and the association with the patients' characteristics, type of surgery performed, presence of systemic or ocular diseases, and subjective patient satisfaction was analyzed. RESULTS: The preoperative visual acuity in the operated eye had a low correlation (0.11) with the quality-of-life score; visual acuity in the better eye had a higher correlation (0.29). Quality-of-life improvement was moderately correlated with visual acuity improvement and patient satisfaction. Overall, quality-of-life scoring improved in all domains after surgery, with an overall effect size of 0.68. Quality-of-life scores improved postoperatively in 83.6% of patients, did not change in 3.6%, and were worse in 12.7%. Visual acuity improved in 94.5%, remained the same in 2.7%, and was worse in 2.7%. There was no difference in quality-of-life improvement between extracapsular cataract extraction and phacoemulsification at 4 months. Patients with systemic or ocular diseases and those who were phakic in the fellow eye had lower quality-of-life improvement; however, this was statistically significant for systemic diseases only. Age and sex did not affect quality of life or its improvement. CONCLUSIONS: The quality of life and surgical outcomes in cataract patients were assessed by a simple questionnaire. The local culture and environment should be taken into consideration in the questionnaire design.