Abstract
Objectives
To evaluate the effect of cataract surgery on vision-related quality of life (VR-QOL) in cataract patients with high myopia (HM).
Methods
In this prospective study, 90 patients with bilateral HM (HM group, mean [SD] age, 62.9 [9.7] years) and 90 age-matched patients with normal axial lengths (ALs) (control group) who underwent phacoemulsification surgery were consecutively included. The VR-QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) preoperatively and 6 months postoperatively. During the same periods, the best-corrected visual acuity (BCVA) was recorded.
Results
Postoperatively, the BCVA improved significantly in the HM group, with 78 patients (86.7%) achieving improvements ≥0.2 logMAR units, higher than that in the control group (61.1%, P < 0.001). Although the preoperative NEI-VFQ-25 composite score was lower in the HM group than in the control group (65.8 ± 4.7 [95% CI] versus 77.3 ± 3.8, P < 0.001), the postoperative composite score was not significantly different between the two groups (87.5 ± 2.6 versus 90.4 ± 1.6, P = 0.126); changes in composite score and scores of 7 subscales were greater in the HM group than in the control group (P < 0.05 for all). In the HM group, but not in the control group (r = −0.019, P = 0.860), patient age was negatively associated with the change in composite score (r = −0.235, P = 0.026). Preoperative BCVA (logMAR) was positively associated with changes in composite score for both groups (r = 0.796 and 0.714, respectively, P < 0.001 for both).
Conclusions
VR-QOL is significantly impaired in cataract patients with HM and is remarkably improved by cataract surgery. The improvement is greater than that in normal AL cases.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, et al. The epidemics of myopia: aetiology and prevention. Prog Retin Eye Res. 2018;62:134–49.
Praveen MR, Vasavada AR, Jani UD, Trivedi RH, Choudhary PK. Prevalence of cataract type in relation to axial length in subjects with high myopia and emmetropia in an Indian population. Am J Ophthalmol. 2008;145:176–81.
Kanthan GL, Mitchell P, Rochtchina E, Cumming RG, Wang JJ. Myopia and the long-term incidence of cataract and cataract surgery: the Blue Mountains Eye Study. Clin Exp Ophthalmol. 2014;42:347–53.
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036–42.
Tan Y, Liu L, Li J, Qin Y, Sun A, Wu M. Evaluation of preoperative corneal astigmatism using swept-source optical biometry in Chinese cataract surgery candidates with high myopia: a prospective, comparative observational study. Ann Transl Med. 2021;9:618.
Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS. Cataracts. Lancet. 2017;390:600–12.
Clarke EL, Evans JR, Smeeth L. Community screening for visual impairment in older people. Cochrane Database Syst Rev. 2018;2:CD001054.
Gimbel HV, Dardzhikova AA. Consequences of waiting for cataract surgery. Curr Opin Ophthalmol. 2011;22:28–30.
Chiang PP, Zheng Y, Wong TY, Lamoureux EL. Vision impairment and major causes of vision loss impacts on vision-specific functioning independent of socioeconomic factors. Ophthalmology. 2013;120:415–22.
Stolk-Vos AC, Visser MS, Klijn S, Timman R, Lansink P, Nuijts R, et al. Effects of clinical parameters on patient-reported outcome in cataract patients: a multicentre study. Acta Ophthalmol. 2018;96:586–91.
Lamoureux EL, Fenwick E, Pesudovs K, Tan D. The impact of cataract surgery on quality of life. Curr Opin Ophthalmol. 2011;22:19–27.
Tsai CY, Chang TJ, Kuo LL, Chou P, Woung LC. Visual outcomes and associated risk factors of cataract surgeries in highly myopic Taiwanese. Ophthalmologica. 2007;221:18–23.
Cetinkaya S, Acir NO, Cetinkaya YF, Dadaci Z, Yener Hİ, Saglam F. Phacoemulsificatıon in eyes wıth cataract and high myopia. Arq Bras Oftalmol. 2015;78:286–9.
Fang Y, Lu Y, Miao A, Luo Y. Aspheric intraocular lenses implantation for cataract patients with extreme myopia. ISRN Ophthalmol. 2014;2014:403432.
Chong EW, Mehta JS. High myopia and cataract surgery. Curr Opin Ophthalmol. 2016;27:45–50.
Fesharaki H, Peyman A, Rowshandel M, Peyman M, Alizadeh P, Akhlaghi M, et al. A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length. Adv Biomed Res. 2012;1:67.
Tan AG, Kifley A, Tham YC, Shi Y, Chee ML, Sabanayagam C, et al. Six-year incidence of and risk factors for cataract surgery in a multi-ethnic Asian population: The Singapore Epidemiology of Eye Diseases Study. Ophthalmology. 2018;125:1844–53.
Jeon S, Kim HS. Clinical characteristics and outcomes of cataract surgery in highly myopic Koreans. Korean J Ophthalmol. 2011;25:84–89.
Zhang M, Jing Q, Chen J, Jiang Y. Analysis of corneal higher-order aberrations in cataract patients with high myopia. J Cataract Refract Surg. 2018;44:1482–90.
Zhang J, Tan X, Wang W, Yang G, Xu J, Ruan X, et al. Effect of axial length adjustment methods on intraocular lens power calculation in highly myopic eyes. Am J Ophthalmol. 2020;214:110–8.
Wang SK, Guo Y, Liao C, Chen Y, Su G, Zhang G, et al. Incidence of and factors associated with myopia and high myopia in Chinese children, based on refraction without cycloplegia. JAMA Ophthalmol. 2018;136:1017–24.
Wei S, Sun Y, Li S, Hu J, Yang X, Lin C, et al. Refractive errors in university students in Central China: The Anyang University Students Eye Study. Invest Ophthalmol Vis Sci. 2018;59:4691–4700.
Ohno-Matsui K, Kawasaki R, Jonas JB, Cheung CM, Saw SM, Verhoeven VJ, et al. International photographic classification and grading system for myopic maculopathy. Am J Ophthalmol. 2015;159:877–83.
Gökce SE, Montes De Oca I, Cooke DL, Wang L, Koch DD, Al-Mohtaseb Z. Accuracy of 8 intraocular lens calculation formulas in relation to anterior chamber depth in patients with normal axial lengths. J Cataract Refract Surg. 2018;44:362–8.
Holladay JT. Visual acuity measurements. J Cataract Refract Surg. 2004;30:287–90.
Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD, et al. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001;119:1050–8.
Zhu M, Yu J, Zhang J, Yan Q, Liu Y. Evaluating vision-related quality of life in preoperative age-related cataract patients and analyzing its influencing factors in China: a cross-sectional study. BMC Ophthalmol. 2015;15:160.
Chan CW, Wong D, Lam CL, McGhee S, Lai WW. Development of a Chinese version of the National Eye Institute Visual Function Questionnaire (CHI-VFQ-25) as a tool to study patients with eye diseases in Hong Kong. Br J Ophthalmol. 2009;93:1431–6.
Lam JK, Chan TC, Ng AL, Chow VW, Wong VW, Jhanji V. Outcomes of cataract operations in extreme high axial myopia. Graefes Arch Clin Exp Ophthalmol. 2016;254:1811–7.
Yokoi T, Moriyama M, Hayashi K, Shimada N, Tomita M, Yamamoto N, et al. Predictive factors for comorbid psychiatric disorders and their impact on vision-related quality of life in patients with high myopia. Int Ophthalmol. 2014;34:171–83.
Beck RW, Maguire MG, Bressler NM, Glassman AR, Lindblad AS, Ferris FL. Visual acuity as an outcome measure in clinical trials of retinal diseases. Ophthalmology. 2007;114:1804–9.
Acknowledgements
We gratefully acknowledge Dr W W Lai for providing the Chinese version of the NEI-VFQ-25 and Prof. Qing Liu for providing statistical assistance.
Funding
This study was supported by grants for the National Key Research and Development Program of China (grant No. 2017YFC1104603) and the National Natural Science Foundation of China (grant No. 81770909 and grant No. 81970783). The funding organization had no role in the design or conduct of this research, or writing of the manuscript.
Author information
Authors and Affiliations
Contributions
(I) Conception and design: YT, MW; (II) Administrative support: MW; (III) Provision of study materials or patients: LL, YQ, AS, MW; (IV) Collection and assembly of data: LL, JL, YQ, AS; (V) Data analysis and interpretation: YT, LL, JL, MW; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Tan, Y., Liu, L., Li, J. et al. Effect of cataract surgery on vision-related quality of life among cataract patients with high myopia: a prospective, case-control observational study. Eye 36, 1583–1589 (2022). https://doi.org/10.1038/s41433-021-01697-6
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-021-01697-6
This article is cited by
-
A 10-year retrospective study on the prevalence and biometric characteristics of high myopia in Chinese cataract surgery candidates
Scientific Reports (2025)
-
Comparison of bilateral implantation of monofocal intraocular lenses with enhanced intermediate function targeting with − 2.00 D and emmetropia in moderate to high myopic Asian patients
Eye and Vision (2024)
-
Comparison of visual outcomes in patients with cataracts and high myopia after implantation of a zonal refractive multifocal or diffractive bifocal intraocular lens
Scientific Reports (2024)
-
Macular vascular density and visual function after phacoemulsification in cataract patients with non-pathological high myopia: a prospective observational cohort study
Graefe's Archive for Clinical and Experimental Ophthalmology (2022)
-
Application of Andersen–Newman model to assess cataract surgery uptake among older Australian women: findings from the Australian Longitudinal Study on Women’s Health (ALSWH)
Aging Clinical and Experimental Research (2022)
