title: Improvements in visual ability with first-eye, second-eye, and bilateral cataract surgery measured with the visual symptoms and quality of life questionnaire.
abstract: OBJECTIVE
  To determine whether the Visual Symptoms and Quality of Life Questionnaire (VSQ), which was developed to be sensitive to second-eye cataract surgery, has satisfactory psychometric properties and, if so, to examine first-eye, second-eye, and bilateral cataract surgery outcomes.
  
  
  METHODS
  Ophthalmology Clinic, Flinders Medical Centre, Adelaide, Australia.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  The 26-item VSQ was self-administered by cataract patients before and after cataract surgery and by those on the cataract surgery waiting list. The VSQ was revised by Rasch analysis using preoperative questionnaire data. The surgical outcome measures were logMAR visual acuities and the Rasch-refined VSQ.
  
  
  RESULTS
  The VSQ was self-administered by 92 patients before and after surgery (25 first eye, 38 second eye, and 29 bilateral) and by 147 on the waiting list. The preoperative visual acuity (surgical eye) was similar across groups. Cataract surgery improved visual acuities in all groups; the mean better-seeing eye visual acuity was significantly better (by 2 lines) in second and bilateral surgery patients than in first-eye surgery patients. Preoperative visual disability was significantly higher in patients awaiting cataract surgery in both eyes than in those awaiting second-eye surgery. Postoperatively, visual disability decreased significantly in all groups (first eye, 1.66 logits; second eye, 1.52 logits; bilateral, 2.58 logits). However, a floor effect limited the measurement of visual disability after cataract surgery.
  
  
  CONCLUSIONS
  The revised visual disability scale of the VSQ measured a reduction in visual disability after first, second, and bilateral cataract surgery. However, the VSQ could not measure lower levels of visual disability, suggesting better questionnaires are required.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: NH&MRC Centre for Clinical Eye Research, Department of Optometry and Vision Science, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, South Australia.
authors.forename: Vijaya K
authors.initials: VK
authors.lastname: Gothwal
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wright
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: Jyoti
authors.initials: J
authors.lastname: Khadka
authors.forename: Colm
authors.initials: C
authors.lastname: McAlinden
authors.forename: Konrad
authors.initials: K
authors.lastname: Pesudovs
mesh_terms: D000368:Aged; D002386:Cataract / Q000503:physiopathology; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D019591:Pseudophakia / Q000503:physiopathology; D011594:Psychometrics; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*