LASEK, PRK, LASIK Forum - Operation Auge NPO

[Ron]

1: J Refract Surg. 2006 Jan-Feb;22(1):19-27.

A quality of life comparison of people wearing spectacles or contact lenses or
having undergone refractive surgery.

Pesudovs K, Garamendi E, Elliott DB.

Department of Ophthalmology, Flinders Medical Centre and Flinders University,
Adelaide, South Australia, Australia. Konrad.Pesudovs@flinders.edu.au

PURPOSE: To demonstrate the use of the Quality of Life Impact of Refractive
Correction (QIRC) questionnaire for comparing the quality of life of
pre-presbyopic individuals with refractive correction by spectacles, contact
lenses, or refractive surgery. METHODS: The 20-item QIRC questionnaire was
administered to 104 spectacle wearers, 104 contact lens wearers, and 104
individuals who had undergone refractive surgery (N = 312). These groups were
similar for gender, ethnicity, socioeconomic status, and refractive error. The
main outcome measure was QIRC overall score (scaled from 0 to 100), a measure of
refractive correction related quality of life. Groups were compared for overall
QIRC score and on each question by analysis of variance, adjusted for age, with
post hoc significance testing (Sheffe). RESULTS: On average, refractive surgery
patients scored significantly better (mean QIRC score 50.2 +/- 6.3, F(2,309) =
15.18, P < .001) than contact lens wearers (46.7 +/- 5.5, post hoc P < .001) who
were in turn significantly better than spectacle wearers (44.1 +/- 5.9, post hoc
P < .01). Convenience questions chiefly drove the differences between groups,
although functioning, symptoms, economic concerns, heath concerns, and well
being were also important. Spectacle wearers with low strength prescriptions
(46.18 +/- 5.05) scored significantly better than those with medium strength
prescriptions (42.74 +/- 6.08, F(2,190) = 3.66, P < .05, post hoc P < .05). A
small number (n = 7, 6.7%) of refractive surgery patients experienced
postoperative complications, which impacted quality of life (37.86 +/- 2.13).
CONCLUSIONS: Quality of life was lowest in spectacle wearers, particularly those
with higher corrections. Contact lens wearers had significantly better QIRC
score than spectacle wearers. Refractive surgery patients scored significantly
better than both. However, this was accompanied by a small risk of poor quality
of life due to postoperative complications. The QIRC is an effective outcome
measure for quality of life impact of refractive correction.

PMID: 16447932 [PubMed - indexed for MEDLINE]




The results say that refractive surgery provides the highest quality of life but I found two critical topics in this study:

1. in the Material&Methods section they not mention the preop grade and kind refractive error ( myopia, hyperopia, astigmatism) so they have no preop data. In results they tell: "For the spectacle group, significant differences were noted for self-reported strenght of refractive correction (F 2,190=3.66, P<.05), with post hoc testing showing the low strenght refractive error (46,18+-5.05) had significantly better QUIRC scores than those with medium strenght refractive error (42.74+-6.08, P<.05) Only 15 patients self-reported high refractive error (42.74+-7.4 therefore this group was not significantly different from the low strenght group.

2. in the discussion part: "Although the impact of surgery is most likely the cause of improvement in QUIRC Score, other factors should be considered such as cognitive dissonance."

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