title: Color of intra-ocular lens and cataract type are prognostic determinants of health indices after visual and photoreceptive restoration by surgery.
abstract: BACKGROUND
  This study compared post-operative quality of life and sleep according to the type of cataract opacity and color of the implanted intra-ocular lens (IOL).
  
  
  METHODS
  This is a cohort study and participants were 206 patients (average age 74.1 years) undergoing cataract surgery with the implantation of a clear ultra-violet (UV)-blocking IOL (C) or a yellow blue-light-blocking IOL (Y). Participants were evaluated using the National Eye Institute Visual Function Questionnaire (VFQ-25) and Pittsburgh Sleep Quality Index (PSQI) before surgery and 2 and 7 months after surgery. Changes in sub-scale scores of VFQ-25 and PSQI were compared.
  
  
  RESULTS
  Sub-scale analyses for improvement after surgery revealed significant differences in ocular pain scores on the VFQ-25 (Y>C; the higher the score, the better the outcome). Furthermore, there were significant differences between the two IOLs in terms of the sleep latency score (C>Y) and sleep disturbances score (C>Y). A posterior sub-capsular cataract was significantly correlated with improvements in ocular pain and sleep latency scores. These effects were successfully represented by the change in scores rather than absolute post-operative scores because individual standard of response may often change after intervention, recognized as a response shift phenomenon in patient-reported outcome study. Regarding seasonal differences, patients who had surgery in summer exhibited relatively better sleep quality than those who had surgery in winter.
  
  
  CONCLUSIONS
  Analysis of sub-scales of health indices demonstrated characteristic prognoses for each IOL and cataract type. Cataract surgery may potentially contribute to systemic health in older adults.
authors.affiliation: 1 Department of Ophthalmology, Keio University School of Medicine , Tokyo, Japan .
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ayaki
authors.forename: Kazuno
authors.initials: K
authors.lastname: Negishi
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Suzukamo
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002387:Cataract Extraction; D003116:Color; D058447:Eye Pain / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007564:Japan; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000295:instrumentation*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D020419:Photoreceptor Cells, Vertebrate; D011474:Prosthesis Design; D011788:Quality of Life; D020127:Recovery of Function; D012621:Seasons; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014785:Vision, Ocular