The impact of cataract surgery on visual functioning, vision-related disability and psychological distress: a randomized controlled trial.
OBJECTIVE
Determine whether there are changes in visual functioning, vision-related disability, health status and mood after cataract surgery.


METHODS
45 adults (mean age = 73.7 years) with bilateral cataract needing surgery for the first eye were recruited from public ophthalmology clinics. The Visual Functioning-14 survey assessed visual disability. Minimal angle of resolution tested visual acuity, and the Melbourne Edge Test examined contrast sensitivity. Demographic, psychological, health and medication use variables were examined. Participants were randomized to either an intervention or control arm. Controls were assessed on two occasions at a 3-month interval before having surgery. The intervention group was assessed 1-2 weeks before surgery and then reassessed 3 months after surgery.


RESULTS
Visual functioning improved for those who had cataract surgery with better visual acuity in the better (P = 0.010) and worse (P = 0.028) eye compared with controls. The intervention group reported fewer difficulties with overall vision-related disability (P = 0.0001), reading (P = 0.004) and instrumental activities of daily living (P = 0.010) post-surgery compared with controls. People with improved depression scores (P = 0.048) after surgery had less difficulty with reading compared with those with unchanged or worsened depression scores. Cataract surgery did not improve health status.


CONCLUSIONS
First eye cataract surgery is effective in improving outcomes in visual functioning and disability. Improved mood after surgery was related to less vision-related disability compared with unchanged or worse depression.
Walker
Janine G
JG
Centre for Mental Health Research, Australian National University, Canberra, Australia. janine.walker@anu.edu.au
Anstey
Kaarin J
KJ
Hennessy
Michael P
MP
Lord
Stephen R
SR
von Sanden
Chwee
C
D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000503:physiopathology*; D002387:Cataract Extraction; D015350:Contrast Sensitivity / Q000502:physiology; D003866:Depressive Disorder / Q000503:physiopathology*; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000503:physiopathology*; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*