Chandrasekaran S, Wang J J, Rochtchina E, Mitchell P
Department of Ophthalmology and the Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Australia.
Eye (Lond). 2008 Apr;22(4):479-84. doi: 10.1038/sj.eye.6702854. Epub 2007 May 4.
To assess the long-term outcomes from cataract surgery on self-rated health, and health-related quality of life (HRQOL) in a population-based older sample.
Participants of the Blue Mountains Eye Study at the baseline (n=3654), 5 (n=2335), and 10-year follow-up (n=1952) were interviewed and examined. Questionnaires included an assessment of self-rated health and HRQOL using the 36-item Short-Form Health Survey (SF-36). Incident cataract surgery was defined if participants had cataract surgery since baseline, and confirmed via lens photographic grading.
There was no statistically significant difference in the proportions of participants who experienced a change in self-rated health between those who had incident cataract surgery (14.1% improvement; 29.1% deterioration) and non-surgical subjects (16.7% improvement; 27.0% deterioration). We found no association between incident cataract surgery and the odds for 10-year change in self-rated health, after multivariate adjustment. In contrast, participants who had incident cataract surgery had a significant improvement in the mean scores of 'mental health' domain of HRQOL (+1.60 vs-2.04, P=0.02) and in the mental component score (+1.43 vs-0.82, P=0.02) than participants who did not undergo surgery. Cataract surgery during follow-up had no significant influence on change in mean scores of other domains or in their physical component score of the SF-36 (-2.57 in participants who had incident surgery vs-2.29 in non-surgical participants, P=0.78).
We confirmed long-term improvement following cataract surgery in the mental but not in the physical domain of the SF-36 or in answers to a specific self-rated health question.
在一个基于人群的老年样本中，评估白内障手术对自评健康状况及健康相关生活质量（HRQOL）的长期影响。
对蓝山眼研究中基线期（n = 3654）、5年随访期（n = 2335）和10年随访期（n = 1952）的参与者进行访谈和检查。问卷包括使用36项简短健康调查问卷（SF - 36）对自评健康状况和HRQOL的评估。如果参与者自基线期后接受了白内障手术，则定义为发生白内障手术，并通过晶状体摄影分级进行确认。
在发生白内障手术的参与者（改善14.1%；恶化29.1%）和未接受手术的参与者（改善16.7%；恶化27.0%）中，自评健康状况发生变化的参与者比例无统计学显著差异。多变量调整后，我们发现白内障手术与自评健康状况10年变化的几率之间无关联。相比之下，发生白内障手术的参与者在HRQOL的“心理健康”领域平均得分（+1.60对 - 2.04，P = 0.02）和心理成分得分（+1.43对 - 0.82，P = 0.02）上比未接受手术的参与者有显著改善。随访期间的白内障手术对SF - 36其他领域平均得分的变化或其身体成分得分无显著影响（发生手术的参与者为 - 2.57，未接受手术的参与者为 - 2.29，P = 0.78）。
我们证实白内障手术后在SF - 36的心理领域而非身体领域或特定自评健康问题的回答方面有长期改善。
