TY - JOUR
T1 - Predictors of Outcome in Patients Who Underwent Cataract Surgery
AU - Schein, Oliver D.
AU - Steinberg, Earl P.
AU - Cassard, Sandra D.
AU - Tielsch, James M.
AU - Javitt, Jonathan C.
AU - Sommer, Alfred
N1 - Funding Information:
Supported by grant HS06280 from the Agency for Health Care Policy and Research, Rockville, Maryland. The Johns Hopkins University holds a copyright on the VF-14 and the Cataract Symptom Score. Were the Johns Hopkins University to receive any royalties related to future licensing of these instruments, then, under University policy, the inventors (includes all of the authors of this article) of those instruments would receive a share of those royalties. Reprint requests to Oliver D. Schein, MD, MPH, 116 Wilmer Bldg, Johns Hopkins Hospital,600 North WolfeSt, Baltimore,MD 21287-9091.
PY - 1995
Y1 - 1995
N2 - Purpose: To identify preoperative patient characteristics associated with a lack of improvement on one or more measures 4 months after cataract surgery. Methods: The authors collected preoperative and 4-month postoperative information on 552 patients undergoing first-eye cataract surgery from the practices of 72 ophthalmologists in three cities. The principal outcomes assessed were (1) Snellen visual acuity, (2) a cataract-related symptom score (possible range: 0, 0 of 6 symptoms present or bothersome, to 18, all 6 symptoms very bothersome), and (3) a measure of functional impairment in patients with cataract—the VF-14 score (possible range: 0, inability to perform any of the applicable activities, to 100, no difficulty performing any of the applicable activities). Multiple logistic regression was used to assess the association between preoperative patient characteristics and failure to improve on one or more outcome measures. Multiple linear regression was used to estimate the adjusted rate of lack of improvement in one or more outcome measures for one group of patients compared with another. Results: Although 91 patients (16.5%)failed to improve on one or more of the outcome measures assessed, only 2 (0.4%)failed to improve on all three measures. The 91 patients who did not improve on at least one measure were approximately one sixth as likely to be satisfied with their vision postoperatively as the 461 patients who improved on all three outcome measures. Preoperative age of 75 years of age or older, VF-14 score of 90 or higher, cataract symptom score of 3 or lower, and ocular comorbidity (glaucoma, diabetic retinopathy, or age-related macular degeneration) were associated independently with increased likelihood of not improving on one or more measure (odds ratio: 3.57, 2.10, 3.29, and 2.16, respectively). The mean adjusted rate of failure to improve on at least one of the outcome measures ranged from 20.5% to 26.5% for patients with these preoperative characteristics compared with 8.8% to 13.8% for those patients without them. The preoperative level of Snellen visual acuity was not associated with the likelihood of not improving on one or more of the outcomes assessed. Conclusions: The authors conclude that specific preoperative characteristics (age, comorbidity, cataract symptom score, and VF-14 score) are independent predictors of patient outcome after cataract surgery.
AB - Purpose: To identify preoperative patient characteristics associated with a lack of improvement on one or more measures 4 months after cataract surgery. Methods: The authors collected preoperative and 4-month postoperative information on 552 patients undergoing first-eye cataract surgery from the practices of 72 ophthalmologists in three cities. The principal outcomes assessed were (1) Snellen visual acuity, (2) a cataract-related symptom score (possible range: 0, 0 of 6 symptoms present or bothersome, to 18, all 6 symptoms very bothersome), and (3) a measure of functional impairment in patients with cataract—the VF-14 score (possible range: 0, inability to perform any of the applicable activities, to 100, no difficulty performing any of the applicable activities). Multiple logistic regression was used to assess the association between preoperative patient characteristics and failure to improve on one or more outcome measures. Multiple linear regression was used to estimate the adjusted rate of lack of improvement in one or more outcome measures for one group of patients compared with another. Results: Although 91 patients (16.5%)failed to improve on one or more of the outcome measures assessed, only 2 (0.4%)failed to improve on all three measures. The 91 patients who did not improve on at least one measure were approximately one sixth as likely to be satisfied with their vision postoperatively as the 461 patients who improved on all three outcome measures. Preoperative age of 75 years of age or older, VF-14 score of 90 or higher, cataract symptom score of 3 or lower, and ocular comorbidity (glaucoma, diabetic retinopathy, or age-related macular degeneration) were associated independently with increased likelihood of not improving on one or more measure (odds ratio: 3.57, 2.10, 3.29, and 2.16, respectively). The mean adjusted rate of failure to improve on at least one of the outcome measures ranged from 20.5% to 26.5% for patients with these preoperative characteristics compared with 8.8% to 13.8% for those patients without them. The preoperative level of Snellen visual acuity was not associated with the likelihood of not improving on one or more of the outcomes assessed. Conclusions: The authors conclude that specific preoperative characteristics (age, comorbidity, cataract symptom score, and VF-14 score) are independent predictors of patient outcome after cataract surgery.
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U2 - 10.1016/S0161-6420(95)30952-9
DO - 10.1016/S0161-6420(95)30952-9
M3 - Article
C2 - 7777281
AN - SCOPUS:0029003129
SN - 0161-6420
VL - 102
SP - 817
EP - 823
JO - Ophthalmology
JF - Ophthalmology
IS - 5
ER -