Visual function and subjective perception of visual ability after macular hole surgery - 25/08/11
: FRCS(G), Seyed M.S. Ghazi-Nouri, MBBS, MRCOphth a, Gary S. Rubin, PhD c, Zoe C. Adams, BA a, David G. Charteris a : FRCOphthRésumé |
Purpose |
To evaluate the functional and anatomical results of macular hole surgery and to explore its effect on patients' Health-Related Quality Of Life (HR-QOL) and to investigate the associations between self-reported HR-QOL and conventional measures of visual function.
Design |
Case series.
Methods |
The National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and the 36-Item Short-Form Health Survey (SF-36) were self-administered by 30 patients before and 4 months after macular hole surgery. Preoperative, intraoperative, and postoperative clinical data were collected including visual acuity, contrast sensitivity, and metamorphopsia. Multi-item scales rating different aspects of HR-QOL were compared before and after surgery, and their correlation with traditional methods of outcome evaluation was analyzed.
Results |
Macular hole closure was achieved in 26 patients (87%). Mean LogMAR visual acuity improved by 6 ± 10 letters for distance and 7 ± 12 letters for near. Metamorphopsia was reduced by a mean of 35 ± 70 squares on Amsler chart, and Pelli-Robson contrast sensitivity decreased by a mean of −0.09 ± 0.3 log units postoperatively. The VFQ-25 composite score as well as scale scores associated with general vision, near vision, vision-related mental health, and role difficulties were significantly improved (P < .05) after successful closure of macular hole. Conversely out of the eight SF-36 health concepts, limitation in usual role activities because of emotional problems was the only one that significantly improved postoperatively. Both baseline and postoperative best-corrected visual acuity significantly correlated with most of the VFQ subscale scores before and after surgery, respectively.
Conclusions |
In this case-series, macular hole surgery appears to have a beneficial effect on patients' subjective perception of visual function. The use of vision-targeted health status questionnaires in conjunction with detailed clinical examination provides a more comprehensive overview of individuals' daily well-being after surgical intervention. Further controlled studies are required to confirm our findings.
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Vol 138 - N° 6
P. 995-1002 - décembre 2004 Retour au numéro
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