Key Indicators Determining the “quality of life” of a Patient with Visually Intense Work after Phacoemulsification of Bilateral Cataracts

Purpose : to study the main indicators determining the “quality of life” (QOL) of a patient engaged in visually intense work (VIW), from the standpoint of the medical and social health model) after phacoemulsification (PEC) of bilateral cataracts. Methods . We observed 134 patients (264 eyes), 76 % men and 24 % women, aged 42 to 68 years (mean age 57.2 ± 1.3 years) with the following inclusion criteria for patients in the study: the presence of binocular uncomplicated cataract with best-corrected distance visual acuity in the worst eye no more than 0.4 relative units; in the best eye — no more than 0.6 relative units; everyday activities were characterized as visually intense work (at least 4 hours a day); motivation for cataract surgery sequentially on both eyes; absence of alternative pathology of the organ of vision. All patients underwent ultrasound PEC with intraocular lens (IOL) implantation under local anesthesia using the standard technique through a 2.2–2.4 mm corneal incision. All patients were operated on by the same surgeon (N.I. Ovechkin). The operation on the second eye was usually performed 7–10 days after the operation on the first eye. In this case, a monofocal IOL “Flex HB Medicontur” (Switzerland) with a predicted emmetropic “target refraction” (TR) was implanted to correct aphakia. A comprehensive examination of the state of the organ of vision was performed 2–3 months after the operation on the second eye using the following 39 indicators of the visual system. The research questionnaire QOL “PEC-22” was used as the basic parameter of the examination with the calculation of the total testing indicator as the sum of points for all questions. Results . The leading place in predicting the QOL of a VIW patient after binocular cataract surgery is occupied by anisometropia at all studied distances (far, 60 and 40 cm) measuring uncorrected distance visual acuity (correlation coefficient, CC 0.54–0.66) and the ophthalmoergonomic test “Eye-meter” with a minimum (3 s) time of presentation of the test object (CC = 0.62). Conclusion . The developed predictors are effective methods for assessing the clinical effectiveness of phacoemulsification from the standpoint of the medical and social health model.