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Refractive surgery can improve quality of life
- survey
Laszlo Dosa in Ft. Lauderdale
A quality of life survey instrument developed by British researchers
that compared patients' feelings about spectacles, contact lenses
and refractive surgery appears to give the edge to the latter option.
Konrad Pesudovs PhD told EuroTimes that on the 100-point Quality
of Life Impact of Refractive Correction (QIRC) scale, the mean score
of refractive surgery patients was 50.2. The contact lens group
scored significantly lower, at 46.7, and the spectacle lens group
even lower than that, at 44.1.
British researchers gave the 20-question QIRC questionnaire to 225
people -- 75 in each correction mode -- for validation and to compare
performance between each of the three groups. The only restriction
had to do with age. As the QIRC questionnaire was designed for non-presbyopic
patients, the subjects in the study were all under 40 years of age.
"That is very important because the content of the questionnaire
for presbyopic people would need to be different. Issues relating
to using bifocal or reading glasses, or using multifocals for example
with driving, would be quite different in terms of symptoms, functional
problems, etcetera," Dr. Pesudovs noted.
He added that the necessity to confine the study to pre-presbyopes
became apparent in the early stages of the development of the questionnaire
when it was realized that questions for presbyopes did not fit pre-presbyopes.
The subjects for the study were drawn from 14 optometric practices
and five Ultralase refractive surgery centres spread throughout
the UK. The refractive surgery subjects had undergone LASIK at least
three months prior to filling out the questionnaire. The groups
were matched for age, gender, ethnicity and socio-economic status
and were representative of the overall UK population seeking eye
care.
Quality of lifestyle
Those who had undergone refractive surgery had significantly better
quality of life scores compared to contact lens wearers and spectacle
wearers. Moreover, the advantages of refractive surgery appeared
to be especially pronounced with regard to several specific aspects
of quality of life.
For example, the refractive surgery group had a markedly better
score than contact lens wearers with regard to "eyes feeling
tired or strained" (50.25 vs 44.21) and "seeing on waking"(50.98
vs 42.42). In addition, with regard to the item "How concerned
are you about your vision being not as good as it could be"
the difference in scores was highly significant in favour of refractive
surgery patients, who had a score of 54.42. That compared to 45.90
for the contact lens group and 42.19 for the spectacle wearers.
In general, spectacle wearers fared poorly on psychosocial well-being
items. However, they had better scores than the other two groups
regarding "concerns about medical complications."
Furthermore, a small proportion (6.7%) of the refractive surgery
participants had a very low quality of life score (37.9 + 2.1) due
to post-operative complications such as dry eye and residual refractive
error.
Dr Pesudovs said he believes that the use of Rasch analysis demonstrates
the QIRC questionnaire provides a valid measure of quality of life
in refractive correction. The overall outcome suggests that people
with refractive correction experience good quality of life regardless
of correction type, but correction preference is probably driven
by individual variations as related to quality of life issues.
He
added that the questionnaire could be used in ophthalmic outcomes
research in general. It would be applicable to any research on spectacle
wearers, any research on contact lens wearers, and any research
on refractive surgery. It would be particularly suitable for the
pre- and post-operative study of refractive surgery.
Dr Pesudovs presented his results in a poster presentation at the
annual meeting of the Association for Research in Vision and Ophthalmology.
Konrad
Pesudovs, PhD
University of Bradford, Bradford, UK
konrad@pesudovs.com
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