Vision-related quality of life and visual outcomes from cataract surgery in patients with vision-threatening diabetic retinopathy: a prospective observational study

BACKGROUND To examine the benefit of cataract surgery on visual acuity and vision related quality of life in patients with stabilized vision-threatening diabetic retinopathy. METHODS A total of 126 patients (153 eyes) who were diagnosed with cataract combined with stabilized vision-threatening diabetic retinopathy underwent phacoemulsification. Measurements included the best-corrected visual acuity (BCVA), which was converted into a weighted logarithm of the minimum angle of resolution (logMAR) and vision related quality of life (VRQoL) using the Chinese-version low vision quality of life questionnaire (CLVQOL). RESULTS Three months after phacoemulsification, statistically significant improvements were observed in postoperative weighted logMAR BCVA (Z = -9.390 P < 0.001). In all of the participants, the CLVQOL total scores (Z = -7.995 P <0.001) and four subscale scores including general vision and lighting level (Z = -7.400 P <0.001), mobility level (Z = -6.914 P <0.001), psychological adjustment level (Z = -8.112 P <0.001) and reading, fine work and activities of daily living level (Z = -5.892 P <0.001), all improved significantly after the surgeries. Linear regression analyses indicated that the increase in CLVQOL total scores exhibited a significant correlation with the better postoperative weighted logMAR BCVA, greater gain of weighted logMAR BCVA after surgery, bilateral surgery, and longer duration of diabetic retinopathy. CONCLUSIONS Both visual acuity and the vision related quality of life of the patients with diabetic retinopathy improved significantly after cataract surgery. Cataract surgery is an effective intervention for patients with stabilized diabetic retinopathy.