Şerife BAYRAKTAR, Zafer CEBECİ, Nilüfer GÖZÜM, Ahmet GÜCÜKOĞLU

SENİL KATARAKTI OLAN HASTALARDA OPERASYON ÖNCESİ VE SONRASI GÖRMEYE BAĞLI YAŞAM KALİTESİ DEĞERLENDİRİLMESİ

Amaç: Senil kataraktı olan hastalarda görme işlevine bağlı yaşam kalitesinin operasyon öncesinde ve sonrasında değerlendirilmesi.Gereç-Yöntem: İstanbul Tıp Fakültesi Göz Hastalıkları Anabilim Dalı’nda Fako cerrahisi planlanan hastalara operasyon uygulanmadan önce ve operasyondan en az 3 ay sonra olmak üzere Ulusal Göz Sağlığı Enstitüsü Görme İşlevleri Anketi’nin (NEI-VFQ 25) Türkçe çevirisi uygulandı. Hastaların ayrıca tüm demografik verileri (yaş, cinsiyet, eğitim durumu), oküler bulguları (operasyon öncesinde en iyi düzeltilmiş görme keskinliği (EİDGK), operasyon sonrasında EİDGK, kataraktın tipi, oküler komorbiditeleri gözden geçirildi.Bulgular: Hastaların 19’u kadın (%54,3) ve 16’sı erkekti (%45,7). Hastaların yaşı 35 ile 81 arasında değişmekteydi. 23 hastanın (%65,7) yaşı 60’ın üzerindeydi. Ortalama yaş 66,48±9.98 idi. Operasyon öncesi EİDGK Snellen eşeline göre 0,42±0,2 idi. Operasyon sonrası EİDGK yine Snellen eşeline göre 0,96±0,07 idi. Kadınların operasyon öncesi EİDGK ortalama 0,39±0,2 iken erkeklerin operasyon öncesi EİDGK ortalama 0,46±0,2 idi. NEI-VFQ 25 anketinin ameliyattan önce elde edilen ölçek puan ortalaması 79,03±9,78 iken ameliyat sonrasında bu puanın 99,47±0,74’e yükseldiği tespit edilmiştir (p=0,000). Erkeklerin ameliyat öncesi puan ortalaması 81,8±7,6 iken kadınların puan ortalaması 77,1±10,9 idi. Fakat ameliyat sonrasında her iki grubun da puan ortalamasında istatistiksel olarak anlamlı yükselme olduğu saptandı (t= -10,25, -10,74, p=0,000). Eğitim düzeyi düşük (ilkokul ve altı) ile eğitim düzeyi yüksek (lise ve üstü) iki grup arasında ameliyat öncesi ve sonrası puan ortalamaları farkı istatistiksel olarak anlamlı idi (p=0,000).Sonuç: Katarakt hastalarının görme işlevine bağlı yaşam kalitesi Fako operasyonu sonrasında anlamlı düzeyde artmıştır. Meydana gelen değişiklikleri değerlendirmede NEI-VFQ-TR 25 geçerli ve güvenilir bir ölçek olarak görünmektedir.Anahtar kelimeler: katarakt; Fako; görme işlevi; yaşam kalitesi

Anahtar Kelimeler:

katarakt, Fako, görme işlevi, yaşam kalitesi

ASSESSMENT OF VISION-RELATED QUALITY OF LIFE BEFORE AND AFTER CATARACT SURGERY AMONG SENILE CATARACT PATIENTS

Objective: To assess the vision-releated quality of life before and after the cataract surgery among senile cataract patients. Material and methods: The Turkish translation of National Eye Institute Visual Functioning Questionnaire (NEI-VFQ 25) was surveyed to the patients who were planned to have phaco surgery at Istanbul Medical Faculty, Department of Ophthalmology before and at least 3 months after the surgery. Also demographic data (age, gender, education status), ocular findings (best corrected visual acuity (BCVA) before and after the surgery, type of cataract and ocular comorbidity were evaluated. Results: 19(54,3%) of the patients were female and 16(45,7%) were male. Their ages were between 35 and 81 years. 23(65,7%) patients were older than 60 years. The mean age was 66,48±9.98. BCVA according to the Snellen chart before surgery was 0,42±0,2. After the surgery it was 0,96±0,07. The BCVA of women before the surgery was 0,39±0,2 while the men’s BCVA was 0,46±0,2. The mean score of NEI-VFQ-TR 25 was 79,03±9,78 before the surgery and increased to 99,47±0,74 after the surgery (p=0,000). The men’s mean score was 81,8±7,6 and the women’s mean score was 77,1±10,9 before the surgery. After the surgery stastistically significant increases were seen in all scores (t= -10,25, -10,74, p=0,000). There was a stastically meaningful difference between the mean scores of low educated (primary school and under) and the high educated (high school and upper) groups before and after the surgery(p=0,000). Conclusion: The vision-releated quality of life among cataract patients has improved significantly after the phaco surgery. NEI-VFQ-TR 25 seems to be a valid and reliable tool to assess the difference.Key words: Cataract, phaco, visual function, quality of life,

Keywords:

Cataract, phaco, visual function, quality of life,

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Chitkara DK. Cataract Formation Mechanisms. In: Yanoff M, Duker JS (ed). Ophthalmology Mosby. St Louis, USA, 2nd ed. 2004;273-9.
World Health Organisation. Programme for the prevantion of blindness and deafness. Global initiative for the elimination of avoidable blindness.(WHO/PBL/97.61). Geneva: WHO 1998:1-2.
Javitt JC, Wang F, Trentacost DJ, Rowe M, Tarantino N. Outcomes of cataract extraction with multifocal intraocular lens implantation; functional status and quality of life. Ophthalmology 1997;104:589-99.
Mcleod SD. Beyond Snellen acuity; the assesment of visual function after refractive surgery (editorial). Arch Ophthalmol 2001;119:1371-73.
Toprak AB, Eser E, Guler C, Baser FE, Mayali H. Cross validation of Turkish version 25 item national eye institute visual functioning questionnarie(NEIVFQ 25). Ophthalmic Epidemiol 2005;12(4):259-69
Massof RW, Rubin GS,. Visual Function Assesment Questionnaries. Surv Ophthalmol 2001; 45:531-48.
Mangione CM, Lee PP, Pitts J, Gutierrez P, Berry S, Hays RD. Psychometric properties of the National Eye Institute Visual Function Questionnarie(NEIVFQ). Arch of Ophthalmol 1998;116:1496-504.
Mcleod SD. Beyond Snellen acuity; the assesment of visual function after refractive surgery(editorial). Arch Ophthalmol 2001; 119:1371-3.
Joshua D. Disparities between ophthalmologists and their patients in estimating quality of life. Curr Opin Ophthalmol 2004;15:238-43.
Steinberg Ep, Tielsch JM, Schein OD, et al. The VF14. An index of functional impairment in patients with cataract. Arch Ophthalmol 1994; 112: 630-8.
Nosen PN, Kaplan RM, David K. Measuring outcomes of cataract surgery using the Quality of Well-Being scale and VF-14 Visual function Index. J Cataract Refract Surg 2005;31:369-78.
Musch DC, Farjo AA, Meyer RF, Nehra WM, Janz NK. Assessment of health-releated quality of life after corneal transplantation. Am J Ophthalmol 1997;124:1-8.
Ishii K, Kabata T, Oshika T. The impact of cataract surgery on cognitive impairment and depressive mental status in elderly patients. Am J Ophthalmol 2008;146(3):404-9.
Lundqvist B, Mönestam E. Gender-related differences in cataract surgery outcome: a 5 year follow-up. Acta Ophthalmol 2008;86(5):543-8.
Esteban JJ, Martínez MS, Navalón PG, Serrano OP, Patiño JR, Purón ME, et al. Visual impairment and quality of life: gender differences in the elderly in Cuenca, Spain. Qual Life Res 2008;17(1):37-45.
Clemons ET, Chew EY, Susan BB, McBee W. National Eye Institute Visual Function Questionnaire in the Age-related Eye Disease Study (AREDS). Arch Ophthalmol 2003;121(2): 211-7.
Mangione CM, Lee P, Gutierrez PR, Spritzer K, Berry S, Hays RD. National Eye Institute Visual Function Questionnaire Field Test Investigators. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol 2001;119:1050-8.