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First Author: I.Signes-Soler SPAIN
Co Author(s): J. Javaloy E. Tomás-Verduras J. Calvache-Anaya S. Fernandez-Mota
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We review the recent literature of the impact of cataract surgery from the patient"s perspective in developing countries during the last 10 years.Cataracts are the leading cause of blindness in developing countries. Patient-reported outcome is an important part of the evaluation of a cataract surgery.
A systematic search was completed in Pubmed (Medline) for cataract surgery and quality of life from 2002. From the 318 papers found we select the articles involving developing countries. And only 12 papers match the criteria.
Presumably the quality of life of patients undergoing cataract surgery improves after the intervention. But, is that the case in developing countries? And, what types of instruments are used to assess this? Most of the questionnaires have been constructed for developed countries, as reflected in the choice of items and only few articles study this as only 12 papers matched the criteria. The benefit of cataract surgery, however, on generic health is less clear, due to limited vision-related items. Visual functioning in comorbid eye disease can also improve according to the scientific evidence. Capsular opacification is an important topic to be address to improve the cataract surgical results, and it is showed to improve visual ability beyond that achieved with first eye surgery. But we have to take in consideration that in developing countries, cataract surgery outcomes, whether measured by traditional visual acuity or by patient reported VF/QOL, are at levels many would consider unacceptably low. Much more attention must be given to improve surgery outcomes in the effort to reduce cataract blindness.
The improvements in visual acuity after cataract surgery in developing countries are translated to real improvement in everyday activities, with a component of emotional and community life gains. These improvements can be easily documented with quality of life questionnaires and are independent of the cataract technique. Even low, these improvements are significant with respect to the quality of life of patients before surgery.