Cataract surgery in Australia: a profile of patient-centred outcomes.
BACKGROUND
Few studies have addressed quality of life or satisfaction outcomes for patients undergoing cataract surgery, particularly in Australia. The purpose of this study was to describe a sample of patients undergoing cataract surgery in typical metropolitan practices in Sydney, with a particular focus on the impact upon quality of life and satisfaction with vision.


METHODS
One hundred and eleven patients were recruited prior to surgery and followed through 3 months postoperatively. Patients reported basic demographic information, VF-14 visual disability and SF-36 quality of life information, along with the degree of satisfaction and trouble with vision they experienced. Surgeons' records provided information about type and severity of cataract, refractive error, ocular comorbidity and visual acuity.


RESULTS
Patients enjoyed strongly significant improvement in visual acuity, disability, trouble and satisfaction with vision, with a median postoperative Snellen acuity of 6/7.5, and 82% within 1 D refraction. Not wearing glasses was the most commonly stated patient goal for undergoing surgery. Prior to surgery 23% of all driving patients did so illegally due to poor vision; after surgery 21% of non-drivers began driving again, all legally. Nonetheless, quality of life did not improve. Those who failed to achieve improvements in satisfaction with vision were more likely to be female, have lower educational attainment or have high visual function preoperatively. Change in visual acuity was not predictive.


CONCLUSIONS
The findings from this study indicate that cataract surgery outcomes in Australia compare well with international standards, and emphasize the inadequacy of visual acuity to measure relevant surgical outcomes. Increased preoperative counselling may be required in those groups less likely to attain high levels of satisfaction. Finally, the role of cataract surgery to improve quality of life must be investigated further, as this is the ultimate goal of the procedure.
Department of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South Wales, Australia. ckpager@stanfordalumni.org
Chet K
CK
Pager
Peter J
PJ
McCluskey
Con
C
Retsas
D000368:Aged; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D014792:Visual Acuity