title: Functional and visual acuity outcomes of cataract surgery in Timor-Leste (East Timor).
abstract: OBJECTIVE
  To report functional outcomes following cataract surgery in Timor-Leste.
  
  
  METHODS
  Pre- and post-intervention study measuring visual function improvement following cataract surgery. Presenting visual acuity (VA) was measured and visual function documented using the Indian vision function questionnaire (IND-VFQ).
  
  
  RESULTS
  All 174 persons undergoing cataract surgery from November 2009 to January 2011 in Timor-Leste were included. Mean age was 65.4 years; 113 (64.9%) were male, 143 (82.1%) were from a rural background and 151 (86.8%) were illiterate. Pre-operatively, 77 of 174 patients (44.3%, 95% confidence interval, CI, 37.0-51.7%) were blind (VA ≤3/60), 77 (44.3%, 95% CI 37.0-51.7%) were visually impaired (VA <6/18->3/60), while 20 (11.5%, 95% CI 7.4-16.9%) had presenting acuity ≥6/18 in the better eye. Following surgery, significant improvement in visual function was demonstrated by an effect size of 2.8, 3.7 and 3.9 in the domains of general functioning, psychosocial impact and visual symptoms, respectively. Four weeks following surgery, 85 patients (48.9%, 95% CI 41.5-66.3%) had a presenting VA ≥6/18, 74 (42.5%, 95% CI 35.3-45.9%) were visually impaired and 15 (8.6%, 95% CI 5.0-13.6%) were blind. IND-VFQ improvement occurred even in patients remaining visually impaired or blind following surgery.
  
  
  CONCLUSIONS
  In this setting, cataract surgery led to a significant improvement in visual function but the VA results did not meet World Health Organization quality criteria. IND-VFQ results, although complementary to clinical VA outcomes did not, in isolation, reflect the need to improve program quality.
authors.affiliation: East Timor Eye Programme, Royal Australasian College of Surgeons , Melbourne, Victoria , Australia .
authors.forename: Girish
authors.initials: G
authors.lastname: Naidu
authors.forename: Marcelino
authors.initials: M
authors.lastname: Correia
authors.forename: Praveen
authors.initials: P
authors.lastname: Nirmalan
authors.forename: Nitin
authors.initials: N
authors.lastname: Verma
authors.forename: Ravi
authors.initials: R
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000523:psychology; D002386:Cataract / Q000175:diagnosis / Q000628:therapy; D002387:Cataract Extraction; D005128:Eye Diseases / Q000150:complications / Q000473:pathology; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data
keywords: Cataract surgery; East Timor; Indian vision function questionnaire (IND-VFQ); Timor-Leste; visual acuity; visual function