Authors: Jenny Qian, Tiandra Ceyhan, Joshua Barbosa, Varun Chaudhary

Author Disclosure Block: J. Qian: None. T. Ceyhan: None. J. Barbosa: Investigator initiated study grants; Fight for Sight, Bayer. V. Chaudhary: Advisory panel; Novartis, Bayer. Investigator initiated study grants; Bayer, Novartis, Allergan.

Abstract Body:

Purpose: For cataract surgery, common outcome metrics, foremost of which is visual acuity (VA), are not always aligned with patient benefit. VA testing is performed in tightly controlled environments optimized for sight, which may not capture factors such as glare, contrast sensitivity, and higher order aberrations. Attempts at assigning cataract surgery priority should focus on comprehensive metrics that evaluate potential for change in functional or ‘everyday’ vision. The purpose of this study is to determine the change in functional vision following cataract surgery. 

Study Design: A multi-centered, prospective cohort study. 

Methods: Local research ethics board approval was obtained prior to study commencement. Consenting patients 18 years or older scheduled for cataract surgery at one of five Southern Ontario Hospitals completed a pre-operative and post-operative Catquest-9SF questionnaire, a validated visual disability survey. Change in functional vision was determined by pre-to-post operative change in Catquest scores. Demographic information, VA, and time-to-treatment were also collected at baseline. 

Results: Six-hundred-and-seven recruited patients completed both the baseline and follow-up questionnaires. Mean age was 73.1 ±9.2 years and 47.0% (285 participants) were male. Most patients had a high school or post-secondary education (college, trade school, or university degree) (32.3% and 36.2% respectively). This was the first eye cataract surgery for the majority of patients (67.1%) and on average, patients waited 20.6 ± 18.8 weeks for their surgery. 27.2% of patients had other ocular comorbidities, of which glaucoma (42.4%) was the most common. There was a statistically significant improvement in Catquest scores following cataract surgery, which decreased from 2.04 ± 0.98 pre-operatively to 1.31 ± 0.75 post-operatively (p<0.01). 

Conclusions: In most patients, functional vision improved after cataract surgery as demonstrated by lower post-operative Catquest scores. The use of pre- and post-operative visual disability questionnaires may be more useful in determining visual benefits after cataract surgery than standard visual acuity measurements alone. Future research can be conducted to determine which patient factors may predict a change in functional vision.