Jie-Jin Wang, T. Hong, P. Mitchell
Jul 1, 2014
Asia-Pacific journal of ophthalmology
Dear Editor: I read with interest the article ‘‘Patients’ Short-term Satisfaction With Cataract Surgery and Long-term Sustainability of Improved Visual-Related Quality of Life Over 3 Postoperative Years’’ by Hong et al. I complement the authors on a welldesigned and well-conducted study. Cataract extraction is probably one of the most rewarding surgeries with visual improvement and subsequent improved quality of life. The authors have successfully attempted to document changes felt by the patients after cataract surgery and have demonstrated its long-term sustainability. The authors have used the Visual Function Index Questionnaire (VF-14) and Health-Related Quality of Life instruments. They have done well to analyze separately the groupswith preexisting ocular diseases and systemic conditions that can affect the eye and cause progressive decrease in vision. With time, there is a negative association with improvement in VF-14 score in patients with diabetes. It would be good to know the duration of diabetes and the diabetic status of these patients during the study period. The decrease in the VF-14 score in patients with early age-related macular degeneration and diabetes can be explained by disease progression. The authors have reported that 92% of patients were satisfied with the surgical outcomes at 6 months following cataract surgery, and satisfaction had a poor correlation with an improvement in visual acuity and VF-14 scores. It would be interesting to know the cause of dissatisfaction in the remaining 8%. Nearly 71% patients had improvement in VF-14 scores at 12 months and subtle decrease between 1 and 3 years postoperatively. The study also found that there was a gradual decrease in mean scores at 12 months of both mental component score and physical component score. This is expected considering the age of the patients in the study. Also, the physical and mental component scores are not sensitive to visual function ability changes. The authors have also found that 80% of the patients were satisfied regardless of the improvement in vision following the cataract surgery. This could be better explained by the improved contrast sensitivity following cataract extraction. It would also be interesting to see the refractive error of these patients before and after surgery. I would like to complement the authors once more for an excellent study.