Lau Joseph, Michon John J, Chan Wing-Shing, Ellwein Leon B
Centre for Clinical Trials and Epidemiological Research, The Chinese University of Hong Kong, Hong Kong.
Br J Ophthalmol. 2002 Jan;86(1):12-7. doi: 10.1136/bjo.86.1.12.
Visual acuity, visual functioning, and vision related quality of life outcomes after cataract surgery were assessed in a population based study in a suburban area of Hong Kong.
A cluster sampling design was used to select apartment buildings within housing estates for enumeration. All enumerated residents 60 years of age or over were invited for an eye examination and visual acuity measurement at a site within each estate. Visual functioning (VF) and vision related quality of life (QOL) questionnaires were administered to interview subjects who had undergone cataract surgery and to unoperated people with presenting visual acuity less than 6/60 in either eye, and a sample of those with normal visual acuity.
36.6% of the 310 cataract operated individuals had presenting visual acuity 6/18 or better in both eyes, and 40.0% when measured by pinhole. 4.5% were blind, with presenting visual acuity less than 6/60 in both eyes. Of operated eyes, 59.6% presented with visual acuity 6/18 or better. 11.2% of the operated eyes were blind with vision less than 6/60. Visual acuity outcomes 6/18 or better were marginally associated with surgery in private versus public hospitals. Lens status (pseudophakic versus aphakic) and surgical period (within the most recent 3 years versus before) were not significantly related to vision outcomes. Mean VF and QOL scores decreased consistently with decreasing vision status. Spearman correlation with vision status was 0.420 for VF scores and 0.313 for QOL scores. Among VF/QOL subscales, correlation was strongest for visual perception (r = 0.447) among VF subscales and weakest for self care (r = 0.171) among QOL subscales. Regression adjusted VF and QOL total scores for cataract operated individuals were slightly lower than for those of visually comparable unoperated individuals (p<0.05).
Cataract operations in Hong Kong did not consistently produce good presenting visual acuity outcomes, suggesting that postoperative monitoring would be useful to minimise visual impairment in this population. Although vision outcomes were consistently correlated with all VF/QOL subscale scores, there was a differential impact with VF subscales usually being affected more by reduced acuity than the more general QOL subscales.
在香港郊区的一项基于人群的研究中，对白内障手术后的视力、视觉功能以及与视力相关的生活质量结果进行了评估。
采用整群抽样设计从屋邨内选择公寓楼进行普查。邀请所有60岁及以上的被普查居民在每个屋邨内的一个地点进行眼部检查和视力测量。对接受过白内障手术的受试者、双眼现患视力低于6/60的未手术者以及一部分视力正常者发放视觉功能（VF）和与视力相关的生活质量（QOL）问卷进行访谈。
310例接受白内障手术的患者中，36.6%的患者双眼现患视力达到6/18或更好，针孔视力测量时这一比例为40.0%。4.5%的患者失明，双眼现患视力低于6/60。接受手术的眼睛中，59.6%的视力达到6/18或更好。11.2%的手术眼失明，视力低于6/60。在私立医院与公立医院接受手术的患者中，视力结果达到6/18或更好与手术存在微弱关联。晶状体状态（人工晶状体眼与无晶状体眼）和手术时间（最近3年内与之前）与视力结果无显著相关性。平均VF和QOL评分随视力状态下降而持续降低。VF评分与视力状态的Spearman相关系数为0.420，QOL评分为0.313。在VF/QOL各子量表中，VF子量表中视觉感知的相关性最强（r = 0.447），QOL子量表中自我护理的相关性最弱（r = 0.171）。白内障手术患者经回归调整后的VF和QOL总分略低于视力相当的未手术者（p<0.05）。
香港的白内障手术并非总能产生良好的现患视力结果，这表明术后监测对于减少该人群的视力损害可能有用。尽管视力结果与所有VF/QOL子量表评分均存在一致相关性，但VF子量表受到视力下降的影响通常比更综合的QOL子量表更大。
