Looking at outcomes important to patients may improve results of cataract surgery

July 29, 2013

Cataract surgery can lead to good results from a clinical standpoint yet have poor outcomes from the patient's point of view, reports a study, "Analyzing Patient-Reported Outcomes to Improve Cataract Care", appearing in the August issue of Optometry and Vision Science, official journal of the American Academy of Optometry.

Using well-designed and validated tools to assess patient-reported outcomes can lead to new insights for improving the results of cataract care, suggests the study by Mats Lundström, MD, PhD, of Lund University and Ulf Stenevi, MD, PhD, of Sahlgren's University Hospital, Sweden. Their paper is part of a special theme issue on "Measuring the Patient's Perspective" in optometry research and clinical practice.

Study Compares Clinical and Patient-Reported Outcomes of Cataract Surgery

Using a nationwide registry, Drs Lundström and Stenevi evaluated clinical and patient-reported outcome measures in nearly 10,000 cataract surgeries performed in Sweden between 2001 and 2011. For example, a major clinical outcome measure after is . But improved visual acuity may not always reflect patient ratings of change in vision from before to after the procedure—especially in performing everyday functional tasks.

Not surprisingly, a comparison of the two sets of outcomes found that patient-reported measures were affected by clinical measures. Factors affecting patient-reported outcomes included visual acuity in both the operated and nonoperated eyes, change in visual acuity in the operated eye, and any other eye-related conditions ("ocular comorbidity").

However, more useful information was gained by looking at factors related to better or worse patient-reported outcomes. For example, patients who reported better visual function before surgery or who had poor visual acuity in the nonoperated eye were more likely to have poorer patient-reported outcomes after cataract surgery.

Implications for Decisions about Cataract Care

Ocular comorbidity was also related to worse patient-reported outcomes. These findings may indicate that, as in other chronic diseases, "some patients are too healthy and some too sick to benefit" from cataract surgery, Drs Lundström and Stenevi write. "It is possible that patients who are very satisfied with their vision and have no problems in performing daily life activities should not have cataract surgery at present."

The study also looked at situations where the clinical outcomes were good but patient-reported outcomes were poor—which happened in about seven percent of cataract surgeries. In many of these cases, poor near vision after the procedure was a major contributor to patient dissatisfaction.

There's a growing emphasis on patient-reported outcomes and quality of life in assessing various medical or surgical treatments. But there's been little attention to linking patient-reported outcomes to clinical outcomes in an attempt to improve health care. Age-related cataract is a good model for quality outcome studies: it is a very common, progressive condition that affects daily life and activities, and one for which surgical treatment is effective.

The new study helps vision care professionals in understanding how patient-reported outcome measures might be used to improve on the results of cataract surgery from the patient's perspective. For example, Drs Lundström and Stenevi suggest that surgery could be delayed or not performed in patients who feel they aren't having a lot of problems with daily activities—perhaps especially if they have good near vision.

The special theme issue presents 20 papers on topics related to the use of patient-reported outcomes in vision care. "These papers focus on new tools that are being increasingly used to assess the patient's perspective on a wide range of important conditions, problems, and outcomes," comments Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science. "These measures allow us to rigorously measure the outcomes important to , and to do so in a very meaningful way."

Explore further: Good outcomes for resident-performed cataract surgery

More information: To read the article, "Analyzing Patient-Reported Outcomes to Improve Cataract Care", please visit journals.lww.com/optvissci/Ful … es_to_Improve.6.aspx

Related Stories

Good outcomes for resident-performed cataract surgery

June 4, 2013
(HealthDay)—In an underserved patient population, supervised resident-performed cataract surgery is successful and cost-effective, according to a study published online May 30 in JAMA Ophthalmology.

New optical metrics can identify patients on 'fast track' to decreased vision

June 24, 2013
Sophisticated new optical quality metrics can identify older adults likely to have more rapid age-related declines in vision, suggests a study, "Factors Accounting for the 4-Year Change in Acuity in Patients Between 50 and ...

Older patients have lower risk of hip fracture after cataract surgery

July 31, 2012
Medicare patients 65 years and older who underwent cataract surgery had a lower odds of hip fracture 1 year after the procedure when compared with patients with cataract who did not have cataract surgery, according to a study ...

Soothing sounds during cataract surgery reduces patient anxiety

November 12, 2012
New research shows that the use of an audio therapy known as binaural beats can significantly reduce patients' anxiety during cataract surgery. The 141-patient study, conducted in Thailand, is the first of its kind in cataract ...

Smoking may lead to cataracts in aging population

October 12, 2012
Cigarette smoking is a well-known risk factor for a wide-range of diseases. Now, scientists have evidence that smoking may also increase the risk of age-related cataract, the leading cause of blindness and vision loss in ...

Frequent and longer patient-doctor contact key to dialysis patients' health

July 25, 2013
Both the frequency and duration of patient-doctor contact during dialysis care vary appreciably across countries, and facilities with more frequent and longer contact had fewer patient deaths and hospitalizations, according ...

Recommended for you

Simulations signal early success for fractal-based retinal implants

July 27, 2017
Computer simulations of electrical charges sent to retinal implants based on fractal geometry have University of Oregon researchers moving forward with their eyes focused on biological testing.

Scientists regenerate retinal cells in mice

July 26, 2017
Scientists have successfully regenerated cells in the retina of adult mice at the University of Washington School of Medicine in Seattle.

Genome editing with CRISPR-Cas9 prevents angiogenesis of the retina

July 24, 2017
A research team from the Schepens Eye Research Institute of Massachusetts Eye and Ear has successfully prevented mice from developing angiogenesis of the retina—the sensory tissue at the back of the eye—using gene-editing ...

Too little vitamin D may hinder recovery of injured corneas

July 24, 2017
Injury or disease in combination with too little vitamin D can be bad for the window to your eyes.

Combination of type 2 diabetes and sleep apnoea indicates eyesight loss within four years

July 4, 2017
Research led by the University of Birmingham has discovered that patients who suffer from both Type 2 diabetes and obstructive sleep apnoea are at greater risk of developing a condition that leads to blindness within an average ...

Nearly 60% of pinkeye patients receive antibiotic eye drops, but they're seldom necessary

June 28, 2017
A new study suggests that most people with acute conjunctivitis, or pinkeye, are getting the wrong treatment.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.