Brenner M H, Curbow B, Javitt J C, Legro M W, Sommer A
School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Md.
Arch Ophthalmol. 1993 May;111(5):680-5. doi: 10.1001/archopht.1993.01090050114040.
Evaluation of health care in older populations has increasingly focused on quality of life as a critical outcome of treatment. Vision is assumed to be central to functioning. Data suggest that aging, in itself, is associated with a decline in visual functioning, which, in turn, is related to a decline in physical and mental functioning. Other studies indicate that cataract surgery is followed by significant improvement in vision and visual function. Our objective was to test these assumptions.
Prospective study of 1021 patients, consecutively drawn from 76 randomly selected ophthalmologists' offices in three cities. Structured interviews were completed at baseline, 2 months, and 1 year after entry.
Six hundred thirteen patients with cataracts and 408 other ophthalmic patients drawn from the same offices but treated for other chronic ocular disorders. All received refractive services as needed.
Patients from three cities (Baltimore, Md, St Louis, Mo, and San Diego, Calif) were interviewed once in their homes and twice by telephone.
The study involved the measurement of the effects of usual treatment for cataracts and other degenerative eye diseases.
Visual, social, and psychological functioning.
Within 1 year of treatment, change in visual function was accompanied by significant changes, in the same direction, in quality of life functions: night-time driving, daytime driving, community activities, home activities, mental health, and life satisfaction. In addition, the patients with cataracts showed significantly greater improvement in measures of vision than did the noncataract group.
Regardless of treatment, improvement across quality of life functions occurred when visual function improved. Thus, many types of functional degeneration observed in older populations, attributed to a decline in vision, can be slowed, or even reversed, when visual function is improved. Cataract surgery was effective in improving vision and quality of life functions.
对老年人群医疗保健的评估越来越关注生活质量，将其视为治疗的关键结果。视力被认为是功能的核心要素。数据表明，衰老本身与视觉功能下降有关，而视觉功能下降又与身体和心理功能下降相关。其他研究表明，白内障手术后视力和视觉功能会有显著改善。我们的目的是验证这些假设。
对1021名患者进行前瞻性研究，这些患者连续从三个城市的76个随机选择的眼科医生办公室选取。在基线、入组后2个月和1年时完成结构化访谈。
613名白内障患者以及从同一办公室选取的408名其他眼科患者，后者因其他慢性眼部疾病接受治疗。所有患者均根据需要接受屈光服务。
来自三个城市（马里兰州巴尔的摩、密苏里州圣路易斯和加利福尼亚州圣地亚哥）的患者在家中接受一次访谈，并通过电话接受两次访谈。
该研究涉及测量白内障和其他退行性眼病常规治疗的效果。
视觉、社会和心理功能。
在治疗的1年内，视觉功能的变化伴随着生活质量功能在相同方向上的显著变化：夜间驾驶、日间驾驶、社区活动、家庭活动、心理健康和生活满意度。此外，白内障患者在视力测量方面的改善明显大于非白内障组。
无论治疗如何，当视觉功能改善时，生活质量功能也会得到改善。因此，老年人群中观察到的许多归因于视力下降的功能退化类型，在视觉功能改善时可以减缓甚至逆转。白内障手术在改善视力和生活质量功能方面是有效的。
