TY - JOUR
T1 - Comparison of Patient-Reported Functional Recovery From Different Types of Ophthalmic Surgery
AU - Bicket, Amanda K.
AU - Mihailovic, Aleksandra
AU - Zheng, Chengjie
AU - Kashaf, Michael Saheb
AU - Nagarajan, Niranjani
AU - Huang, Andy S.
AU - Chapagain, Sagar
AU - Da, Joseph
AU - Ramulu, Pradeep Y.
N1 - Funding Information:
All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. Funding/Support: Supported by National Institutes of Health grant no. 5K12EY015025. Financial Disclosures: Amanda K. Bicket has received research support from the National Institutes of Health and Research to Prevent Blindness and has been a consultant for W.L. Gore and Associates, Inc. Pradeep Y. Ramulu has received research support from the National Institutes of Health and has been a consultant for W.L. Gore and Associates, Inc, Aerie Pharmaceuticals, Ivantis, and Harkcon. Aleksandra Mihailovic, Chengjie Zheng, Michael Saheb Kashaf, Niranjani Nagarajan, Andy S. Huang, Sagar Chapagain, and Joseph Da have no financial disclosures. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/7
Y1 - 2021/7
N2 - Purpose: To characterize and compare patient-reported recovery of function after cataract or glaucoma surgery using a novel visual analog scale. Design: Prospective observational cohort study. Methods: Daily for 2 weeks and weekly thereafter, patients recovering from trabeculectomy, tube shunt implantation, or cataract extraction (CE) completed a diary-style questionnaire including visual analog scales (VASs; scored 0-100) grading pain and global function. Clinical examination data and medical histories were collected. Generalized estimating equation models evaluated associations between VAS function scores and pain or visual acuity (VA) and compared scores between surgery types. Results: Among 51 participants followed for 12 weeks, tube shunt placement reduced postoperative day 1 (POD1) function by 47 of 100 points vs CE (P = .006), while trabeculectomy did not reduce POD1 function vs CE (P = .33). After CE, trabeculectomy, and tube shunt placement, average VAS function scores increased 13.94 per week for 2 weeks (P < .001), 4.18 per week for 4 weeks (P = .02), and 7.76 per week for 7 weeks (P < .001), respectively. After those timepoints, there was no further significant change. Beyond 2 weeks, pain levels plateaued, and VA returned to baseline across surgery types; function was inversely related to pain or VA only for the first 2 or 4 weeks, respectively. Conclusions: Patients recovering from cataract and glaucoma surgery report reduced function in the postoperative period. Tube shunt implantation causes greater morbidity than trabeculectomy, and both are associated with slower improvement than CE. Early postoperative function is associated with VA and pain, but neither fully explains reported impairment. A VAS for function may efficiently capture postoperative recovery.
AB - Purpose: To characterize and compare patient-reported recovery of function after cataract or glaucoma surgery using a novel visual analog scale. Design: Prospective observational cohort study. Methods: Daily for 2 weeks and weekly thereafter, patients recovering from trabeculectomy, tube shunt implantation, or cataract extraction (CE) completed a diary-style questionnaire including visual analog scales (VASs; scored 0-100) grading pain and global function. Clinical examination data and medical histories were collected. Generalized estimating equation models evaluated associations between VAS function scores and pain or visual acuity (VA) and compared scores between surgery types. Results: Among 51 participants followed for 12 weeks, tube shunt placement reduced postoperative day 1 (POD1) function by 47 of 100 points vs CE (P = .006), while trabeculectomy did not reduce POD1 function vs CE (P = .33). After CE, trabeculectomy, and tube shunt placement, average VAS function scores increased 13.94 per week for 2 weeks (P < .001), 4.18 per week for 4 weeks (P = .02), and 7.76 per week for 7 weeks (P < .001), respectively. After those timepoints, there was no further significant change. Beyond 2 weeks, pain levels plateaued, and VA returned to baseline across surgery types; function was inversely related to pain or VA only for the first 2 or 4 weeks, respectively. Conclusions: Patients recovering from cataract and glaucoma surgery report reduced function in the postoperative period. Tube shunt implantation causes greater morbidity than trabeculectomy, and both are associated with slower improvement than CE. Early postoperative function is associated with VA and pain, but neither fully explains reported impairment. A VAS for function may efficiently capture postoperative recovery.
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U2 - 10.1016/j.ajo.2021.02.018
DO - 10.1016/j.ajo.2021.02.018
M3 - Article
C2 - 33626362
AN - SCOPUS:85105294939
VL - 227
SP - 201
EP - 210
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -