The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients

Purpose. To determine the changes in vision-related quality of life and psychological distress after cataract surgery in monocular patients and to compared these with a control group of age- and gender-matched binocular patients. Methods. We enrolled 40 monocular patients and 40 binocular patients w...

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Main Authors: Xuepei Li, Jianqiang Lin, Zidong Chen, Guangming Jin, Danying Zheng
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2021/4694577
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author Xuepei Li
Jianqiang Lin
Zidong Chen
Guangming Jin
Danying Zheng
author_facet Xuepei Li
Jianqiang Lin
Zidong Chen
Guangming Jin
Danying Zheng
author_sort Xuepei Li
collection DOAJ
description Purpose. To determine the changes in vision-related quality of life and psychological distress after cataract surgery in monocular patients and to compared these with a control group of age- and gender-matched binocular patients. Methods. We enrolled 40 monocular patients and 40 binocular patients who underwent cataract surgery from August 2017 to December 2018. All participants undertook eye examinations and answered questionnaires (the National Eye Institute Visual Function Questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale) before and after cataract surgery. Result. The monocular patients had significantly worse mean CDVA than the binocular patients before and after surgery. However, there was no significant difference between the increases gained by the two groups. Mean composite VFQ-25 scores of the monocular group were significantly lower than those of the binocular group before and after surgery, but the improvement experienced by the monocular group was statistically larger than the binocular group (37.20 ± 12.84 vs. 19.11 ± 5.13, P<0.001). Mean standard SAS scores of monocular patients were significantly higher than those of binocular controls before and after surgery, while monocular patients experienced a significant greater decline of SAS scores (−9.41 ± 5.39 VS −3.84 ± 1.61, P<0.001). Mean standard SDS scores of the monocular group were significantly higher than those of the control group before and after surgery, but the monocular group experienced a significantly greater decline of SDS scores following cataract surgery (−11.91 ± 6.38 VS −4.78 ± 1.79, P<0.001). There was a significant correlation between the preoperative logMAR CDVA and both the postoperative logMAR CDVA (r = 0.63, P<0.001) and the changes in the logMAR CDVA (r = −0.881, P<0.001) for monocular patients. Linear regression analyses suggested that higher postoperative VFQ-25 scores had significant associations with better preoperative CDVA and the absence of systemic comorbidity (both P<0.05). Age and ocular comorbidity were significantly associated with postoperative SAS scores (both P<0.05). Age and systemic comorbidity remained significant impact factors for SDS scores (both P<0.05). Conclusion. Monocular patients reported greater improvement in vision-related quality of life and greater decline in the level of anxiety and depression than binocular control subjects, despite having similar CDVA gains after cataract surgery. We argue that it is not a better choice for monocular patients to delay cataract surgery until the cataract is very advanced. A clear understanding of the impact of cataract surgery on vision-related quality of life and psychological distress in monocular patients is needed by ophthalmologists when making surgery decision.
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spelling doaj-art-e8b352d8ba274a9c95f3c124d85558632025-08-20T02:22:01ZengWileyJournal of Ophthalmology2090-00582021-01-01202110.1155/2021/4694577The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular PatientsXuepei Li0Jianqiang Lin1Zidong Chen2Guangming Jin3Danying Zheng4State Key Laboratory of OphthalmologyState Key Laboratory of OphthalmologyState Key Laboratory of OphthalmologyState Key Laboratory of OphthalmologyState Key Laboratory of OphthalmologyPurpose. To determine the changes in vision-related quality of life and psychological distress after cataract surgery in monocular patients and to compared these with a control group of age- and gender-matched binocular patients. Methods. We enrolled 40 monocular patients and 40 binocular patients who underwent cataract surgery from August 2017 to December 2018. All participants undertook eye examinations and answered questionnaires (the National Eye Institute Visual Function Questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale) before and after cataract surgery. Result. The monocular patients had significantly worse mean CDVA than the binocular patients before and after surgery. However, there was no significant difference between the increases gained by the two groups. Mean composite VFQ-25 scores of the monocular group were significantly lower than those of the binocular group before and after surgery, but the improvement experienced by the monocular group was statistically larger than the binocular group (37.20 ± 12.84 vs. 19.11 ± 5.13, P<0.001). Mean standard SAS scores of monocular patients were significantly higher than those of binocular controls before and after surgery, while monocular patients experienced a significant greater decline of SAS scores (−9.41 ± 5.39 VS −3.84 ± 1.61, P<0.001). Mean standard SDS scores of the monocular group were significantly higher than those of the control group before and after surgery, but the monocular group experienced a significantly greater decline of SDS scores following cataract surgery (−11.91 ± 6.38 VS −4.78 ± 1.79, P<0.001). There was a significant correlation between the preoperative logMAR CDVA and both the postoperative logMAR CDVA (r = 0.63, P<0.001) and the changes in the logMAR CDVA (r = −0.881, P<0.001) for monocular patients. Linear regression analyses suggested that higher postoperative VFQ-25 scores had significant associations with better preoperative CDVA and the absence of systemic comorbidity (both P<0.05). Age and ocular comorbidity were significantly associated with postoperative SAS scores (both P<0.05). Age and systemic comorbidity remained significant impact factors for SDS scores (both P<0.05). Conclusion. Monocular patients reported greater improvement in vision-related quality of life and greater decline in the level of anxiety and depression than binocular control subjects, despite having similar CDVA gains after cataract surgery. We argue that it is not a better choice for monocular patients to delay cataract surgery until the cataract is very advanced. A clear understanding of the impact of cataract surgery on vision-related quality of life and psychological distress in monocular patients is needed by ophthalmologists when making surgery decision.http://dx.doi.org/10.1155/2021/4694577
spellingShingle Xuepei Li
Jianqiang Lin
Zidong Chen
Guangming Jin
Danying Zheng
The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients
Journal of Ophthalmology
title The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients
title_full The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients
title_fullStr The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients
title_full_unstemmed The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients
title_short The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients
title_sort impact of cataract surgery on vision related quality of life and psychological distress in monocular patients
url http://dx.doi.org/10.1155/2021/4694577
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