Comparison of Patient-Reported Functional Recovery From Different Types of Ophthalmic Surgery.


Journal

American journal of ophthalmology
ISSN: 1879-1891
Titre abrégé: Am J Ophthalmol
Pays: United States
ID NLM: 0370500

Informations de publication

Date de publication:
07 2021
Historique:
received: 03 11 2020
revised: 29 01 2021
accepted: 18 02 2021
pubmed: 25 2 2021
medline: 24 7 2021
entrez: 24 2 2021
Statut: ppublish

Résumé

To characterize and compare patient-reported recovery of function after cataract or glaucoma surgery using a novel visual analog scale. Prospective observational cohort study. Daily for 2 weeks and weekly thereafter, patients recovering from trabeculectomy, tube shunt implantation, or cataract extraction (CE) completed a diary-style questionnaire including visual analog scales (VASs; scored 0-100) grading pain and global function. Clinical examination data and medical histories were collected. Generalized estimating equation models evaluated associations between VAS function scores and pain or visual acuity (VA) and compared scores between surgery types. Among 51 participants followed for 12 weeks, tube shunt placement reduced postoperative day 1 (POD1) function by 47 of 100 points vs CE (P = .006), while trabeculectomy did not reduce POD1 function vs CE (P = .33). After CE, trabeculectomy, and tube shunt placement, average VAS function scores increased 13.94 per week for 2 weeks (P < .001), 4.18 per week for 4 weeks (P = .02), and 7.76 per week for 7 weeks (P < .001), respectively. After those timepoints, there was no further significant change. Beyond 2 weeks, pain levels plateaued, and VA returned to baseline across surgery types; function was inversely related to pain or VA only for the first 2 or 4 weeks, respectively. Patients recovering from cataract and glaucoma surgery report reduced function in the postoperative period. Tube shunt implantation causes greater morbidity than trabeculectomy, and both are associated with slower improvement than CE. Early postoperative function is associated with VA and pain, but neither fully explains reported impairment. A VAS for function may efficiently capture postoperative recovery.

Identifiants

pubmed: 33626362
pii: S0002-9394(21)00083-0
doi: 10.1016/j.ajo.2021.02.018
pmc: PMC8386507
mid: NIHMS1703038
pii:
doi:

Types de publication

Comparative Study Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

201-210

Subventions

Organisme : NEI NIH HHS
ID : K12 EY015025
Pays : United States

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

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Auteurs

Amanda K Bicket (AK)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.. Electronic address: abicket@med.umich.edu.

Aleksandra Mihailovic (A)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Chengjie Zheng (C)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Michael Saheb Kashaf (MS)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Niranjani Nagarajan (N)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Andy S Huang (AS)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Sagar Chapagain (S)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Joseph Da (J)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Pradeep Y Ramulu (PY)

From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

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