白内障手术的获益：视觉功能与生活质量。
Gains from cataract surgery: visual function and quality of life.
作者信息
Desai P, Reidy A, Minassian D C, Vafidis G, Bolger J
机构信息
Royal College of Ophthalmologists, London.
出版信息
Br J Ophthalmol. 1996 Oct;80(10):868-73. doi: 10.1136/bjo.80.10.868.
AIMS
To describe the impact of cataract surgery in terms of visual function (functioning in everyday life with respect to vision dependent activities) and health related quality of life.
METHODS
An observational, longitudinal study of patients undergoing cataract surgery was carried out at three district general hospitals in outer London districts of North Thames Region with follow up at 4 and 12 months postoperatively for a clinical assessment and a standardised administered interview. Patients were admitted for surgery to the first eye for age-related cataract between 1 May 1993 and 31 August 1994. Visual functioning was assessed by the VF-14, health related quality of life was assessed by the sickness impact profile (SIP), and vision related quality of life was assessed by VR-SIP (a modification of the generic SIP).
RESULTS
Significant gains in all the outcome measures were demonstrated at 4 months postoperatively. No significant change (gain or loss) was observed between 4 and 12 months after surgery to the first eye. Postoperatively, the mean visual function (VF-14) scores, and health related (SIP) and vision related (VR-SIP) quality of life scores, indicated less reported trouble with vision dependent activities and better perceived quality of life, respectively. The average gains in visual function and quality of life (health and vision related) were apparent in groups with good visual outcome and poor visual outcome. Significant additional gains were seen at 1 year in patients who had second eye surgery in the interval between the postoperative assessments.
CONCLUSIONS
Gains in visual functioning and quality of life (health and vision related) have been demonstrated following cataract surgery. These gains were sustained at 1 year after surgery to the first eye, with additional gains being conferred if second eye surgery had been performed. Assessment of the outcomes of cataract surgery by clinical indicators alone may underestimate the overall benefits of surgery, particularly in patients with poor visual outcome.
目的
描述白内障手术在视觉功能（在依赖视力的日常活动中的功能表现）以及与健康相关的生活质量方面的影响。
方法
在北泰晤士地区伦敦外围的三家区综合医院，对接受白内障手术的患者进行了一项观察性纵向研究，并在术后4个月和12个月进行随访，以进行临床评估和标准化管理访谈。1993年5月1日至1994年8月31日期间，患者因年龄相关性白内障首次入院接受手术。通过VF - 14评估视觉功能，通过疾病影响量表（SIP）评估与健康相关的生活质量，通过VR - SIP（通用SIP的一种修改版本）评估与视力相关的生活质量。
结果
术后4个月时，所有结局指标均有显著改善。对第一眼手术后4个月至12个月期间未观察到显著变化（改善或下降）。术后，平均视觉功能（VF - 14）得分以及与健康相关（SIP）和与视力相关（VR - SIP）的生活质量得分分别表明，在依赖视力的活动中报告的问题减少，以及生活质量的感知更好。在视觉结局良好和视觉结局较差的组中，视觉功能和生活质量（与健康和视力相关）的平均改善均很明显。在术后评估间隔期间接受了第二眼手术的患者中，1年后有显著的额外改善。
结论
白内障手术后视觉功能以及生活质量（与健康和视力相关）得到了改善。这些改善在第一眼手术后1年持续存在，如果进行了第二眼手术则会有额外改善。仅通过临床指标评估白内障手术的结局可能会低估手术的总体益处，尤其是在视觉结局较差的患者中。
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