Comparison of patient-reported functional recovery from different types of ophthalmic surgery.
To characterize and compare patient-reported recovery of function after cataract or glaucoma surgery using a novel visual analog scale.Prospective observational cohort study METHODS: : Daily for two weeks and weekly thereafter, patients recovering from trabeculectomy, tube shunt implantation, or cataract extraction (CE) completed a diary-style questionnaire including visual analog scales (VAS; scored 0-100) grading pain and global function. Clinical exam data and medical histories were collected. Generalized estimating equation models evaluated associations between VAS function scores and pain or visual acuity, and compared scores between surgery types.Among 51 participants followed for 12 weeks, tube shunt placement reduced post-operative day 1 (POD1) function by 47/100 points versus CE (p=0.006), while trabeculectomy did not reduce POD1 function versus CE (p=0.33). Following CE, trabeculectomy, and tube shunt placement, average VAS function scores increased 13.94 per week for 2 weeks (p<0.001), 4.18 per week for 4 weeks (p=0.02), and 7.76 per week for 7 weeks (p<0.001), respectively. After those timepoints, there was no further significant change. Beyond 2 weeks, pain levels plateaued and visual acuity (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 post-operative period. Tube shunt implantation causes greater morbidity than trabeculectomy, and both are associated with slower improvement than CE. Early post-operative function is associated with VA and pain, but neither fully explains reported impairment. A VAS for function may efficiently capture post-operative recovery.
Authors: Amanda K Bicket, Aleksandra Mihailovic, Chengjie Zheng, Michael Saheb Kashaf, Niranjani Nagarajan, Andy S Huang, Sagar Chapagain, Joseph Da, Pradeep Y Ramulu