Polack Sarah, Eusebio Christina, Mathenge Wanjiku, Wadud Zakia, Mamunur A K M, Fletcher Astrid, Foster Allen, Kuper Hannah
London School of Hygiene & Tropical Medicine, London, UK.
Ophthalmic Epidemiol. 2010 Dec;17(6):387-99. doi: 10.3109/09286586.2010.528136.
To assess the impact of cataract surgery on vision related quality of life (VRQoL) and generic health related quality of life (HRQoL) in Kenya, Bangladesh and the Philippines.
A multi-center intervention study was conducted. At baseline 651 cases aged ≥50 years with visually impairing cataract (corrected visual acuity (VA) <6/24) and 561 age- gender-matched controls with normal vision (VA>6/18) were interviewed about VRQoL (using the World Health Organization/ Prevention of Blindness and Deafness 20-item Visual Functioning Questionnaire [WHO/PBD VF20]) and generic HRQoL (EuroQol). Cases were offered free/subsidized cataract surgery. Approximately 1 year later participants were re-interviewed.
Response rate at follow up was 84% for operated cases and 80% for controls. At baseline, cases had significantly poorer VRQoL scores, were more likely to report problems with the EuroQol 5D five descriptive (EQ-SD) domains (mobility, daily activities, self-care, pain, depression/anxiety) and had significantly poorer self-rated health compared to controls. At follow up VRQoL scores of operated cases improved significantly to approximately equal those of controls. Effect sizes were large (> 0.8) regardless of pre-operative VA. Poor outcome from surgery (VA < 6/60) was associated with smaller VRQoL gains. Among operated cases frequency of reported problems with all the EQ-5D reduced significantly compared to baseline in Kenya and the Philippines, and in mobility, daily activities and self-care in Bangladesh. Self-rated health scores increased significantly in each country. HRQoL of controls remained stable from baseline to follow up.
This study among adults undergoing cataract surgery in 3 different low-income settings found evidence of improved VRQoL and generic HRQoL to approximately equal that of controls with normal vision.
评估白内障手术对肯尼亚、孟加拉国和菲律宾与视力相关的生活质量（VRQoL）以及一般健康相关生活质量（HRQoL）的影响。
开展了一项多中心干预研究。在基线时，对651例年龄≥50岁、患有导致视力损害的白内障（矫正视力（VA）<6/24）的患者以及561例年龄和性别匹配、视力正常（VA>6/18）的对照者进行了关于VRQoL（使用世界卫生组织/防盲治聋20项视觉功能问卷[WHO/PBD VF20]）和一般HRQoL（欧洲五维度健康量表）的访谈。为患者提供免费/补贴的白内障手术。大约1年后对参与者进行再次访谈。
手术病例的随访应答率为84%，对照者为80%。在基线时，与对照者相比，患者的VRQoL得分显著更低，更有可能报告在欧洲五维度健康量表5个描述性（EQ-5D）领域（行动能力、日常活动、自我护理、疼痛、抑郁/焦虑）存在问题，且自我评定健康状况显著更差。在随访时，手术病例的VRQoL得分显著改善，大致与对照者相当。无论术前视力如何，效应量都很大（>0.8）。手术效果不佳（VA<6/60）与VRQoL改善较小相关。在手术病例中，在肯尼亚和菲律宾，所有EQ-5D领域报告问题的频率与基线相比显著降低，在孟加拉国，行动能力、日常活动和自我护理领域报告问题的频率显著降低。每个国家的自我评定健康得分均显著提高。对照者的HRQoL从基线到随访保持稳定。
这项针对3个不同低收入环境中接受白内障手术的成年人的研究发现，有证据表明VRQoL和一般HRQoL得到改善，大致与视力正常的对照者相当。
