Validation, test-retest reliability and norm scores for the Dutch Catquest-9SF

Patient-reported visual function outcomes in immediately sequential versus delayed sequential bilateral cataract surgery

PURPOSE

To compare patient-reported visual function outcomes of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS).

METHODS

Single-center, randomised controlled trial of patients eligible for bilateral cataract surgery allocated to ISBCS or DSBCS. Patients filled out the Catquest-7SF questionnaire before surgery, 1 week after surgery, and 3 months after surgery.

RESULTS

Ninety-eight patients were included for analysis (ISBCS = 51; DSBCS = 47). In both groups, there was a statistically significant improvement in Catquest-7SF patient-reported outcomes after surgery (p < 0.001), and no difference between the ISBCS and DSBCS groups (p ≥ 0.424). At both 1 week and 3 months post-surgery, a statistically significantly higher proportion of patients were "very satisfied" with the surgical approach in the ISBCS group (94.1% at both 1 week and 3 months) compared to the DSBCS group (55.3% at 1 week and 63.8% at 3 months), both p < 0.001.

CONCLUSIONS

Both ISBCS and DSBCS are effective options to treat bilateral cataracts with no statistically significant difference in patient-reported vision outcomes. However, we found postoperative satisfaction with the surgical approach to be higher among ISBCS patients, which suggests that ISBCS-related benefits, such as fewer health care visits and shorter vision rehabilitation, are compelling to patients.

Two novel extended depth-of-focus intraocular lenses targeted for mini-monovision: a prospective randomized controlled trial

PURPOSE

To compare the visual outcomes of two extended depth-of-focus (EDOF) intraocular lenses (IOLs).

DESIGN

Single-center prospective randomized controlled trial.

METHODS

Patients undergoing bilateral cataract surgery were randomly assigned to receive either the Acunex Vario IOL (Teleon Surgical B.V., Spankeren, The Netherlands) or the AcrySof IQ Vivity IOL (Alcon, Geneva, Switzerland); both Vario- and Vivity-group were targeted for mini-monovision. The primary outcome was the uncorrected intermediate visual acuity (UIVA, measured at 66cm). Secondary outcome parameters were uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), defocus curves, reading speed, contrast sensitivity, spectacle independence and quality of vision.

SETTING

University Eye Clinic, Maastricht University Medical Center+, the Netherlands.

RESULTS

A total of 31 subjects (62 eyes) were included, 16 patients were enrolled into the Vario-group and 15 patients into the Vivity-group. At three months postoperatively, no statistically significant differences were found for the binocular visual acuities between the groups after adjustment for covariates. The mean and standard deviation for the binocular UIVA was 0.04±0.11 and 0.15±0.11 logMAR (adjusted-P=0.264) for the Vario- and Vivity-group, respectively. The binocular UDVA was 0.00±0.14 and 0.08±0.10 logMAR (adjusted-P=0.753), and UNVA was 0.22±0.17 and 0.31±0.14 logMAR (adjusted-P=0.235), for both groups, respectively. While the Vario-group had a larger range of defocus, no significant differences were found for patient satisfaction and spectacle independence. Contrast sensitivity and reading speed were comparable, and there were no statistically significant differences in optical side effects between the groups.

CONCLUSION

Bilateral implantation of the Acunex Vario IOL and the AcrySof IQ Vivity IOL targeted for mini-monovision had comparable results for binocular visual acuity outcomes, contrast sensitivity, optical side effects, and reading speed. The Vario-group showed a larger continuous range of defocus.

Web-based telemonitoring of visual function and self-reported postoperative outcomes in cataract care: international multicenter randomized controlled trial

PURPOSE

To compare web-based, self-administered follow-up after cataract surgery to conventional face-to-face follow-up.

SETTING

Eye clinics in the Netherlands, Austria, and Germany.

DESIGN

Randomized controlled trial with an embedded method comparison study (ClinicalTrials.gov: NCT04809402).

METHODS

Routine patients with cataract were randomized into 2 groups: The telemonitoring group undertook web-based vision self-assessments and questionnaires from home, while the usual care group received conventional care. All participants had a 4- to 6-week postoperative clinic visit for safety and validation purposes. Outcomes included, the web test's accuracy for assessing postoperative visual acuity (VA) and refractive error, adverse event rates, and patient-reported outcome measurements (PROMs).

RESULTS

94 participants (188 eyes) were enrolled. Web-based uncorrected distance VA testing demonstrated a negligible mean difference (-0.03 ± 0.14 logMAR) when compared with conventional Early Treatment Diabetic Retinopathy Study chart testing, with 95% limits of agreement ranging from -0.30 to 0.24 logMAR. The web-based refraction assessment overestimated the postoperative refractive error (mean difference in spherical equivalent 0.15 ± 0.67 diopters), resulting in a poorer corrected distance VA compared with subjective refraction (mean 0.1 vs -0.1 logMAR). Rates of adverse events and unscheduled consultations were minimal across both groups. Preoperative and postoperative PROM questionnaires had a 100% response rate. Visual functioning (Catquest-9SF and National Eye Institute Visual Function Questionnaire-25) improved postoperatively (mean improvement -0.80 and 16.70, respectively) and did not significantly differ between the 2 groups.

CONCLUSIONS

The patients with cataract in this study effectively provided postoperative outcome data using a web interface. Both conventional and web-based follow-ups yielded similar PROMs and adverse event rates. Future developments should reduce the variability in the web-based VA test and yield representative refraction outcomes.

Multi-center validation of Catquest-9SF visual function questionnaire in Ontario, Canada

PURPOSE

To investigate the psychometric performance and responsiveness of Catquest-9SF, a patient-reported questionnaire developed to evaluate visual function as related to daily tasks, in patients referred for cataract surgery in Ontario, Canada.

METHODS

This is a pooled analysis on prospective data collected for previous projects. Subjects were recruited from three tertiary care centers in Peel region, Hamilton, and Toronto, Ontario, Canada. Catquest-9SF was administered pre-operative and post-operatively to patients with cataract. Psychometric properties, including category threshold order, infit/outfit, precision, unidimensionality, targeting, and differential item functioning were tested using Rasch analysis with Winsteps software (v.4.4.4) for Catquest-9SF. Responsiveness of questionnaire scores to cataract surgery was assessed.

RESULTS

934 patients (mean age = 71.6, 492[52.7%] female) completed the pre- and post-operative Catquest-9SF questionnaire. Catquest-9SF had ordered response thresholds, adequate precision (person separation index = 2.01, person reliability = 0.80), and confirmed unidimensionality. The infit range was 0.75-1.29 and the outfit range was 0.74-1.51, with one item ('satisfaction with vision') misfitting (outfit value = 1.51). There was mistargeting of -1.07 in pre-operative scores and mistargeting of -2.43 in both pre- and post-operative scores, meaning that tasks were relatively easy for respondent ability. There was no adverse differential item functioning. There was a mean 1.47 logit improvement in Catquest-9SF scores after cataract surgery (p<0.001).

CONCLUSION

Catquest-9SF is a psychometrically robust questionnaire for assessment of visual function in patients with cataract in Ontario, Canada. It is also responsive to clinical improvement after cataract surgery.

Catquest-9SF questionnaire: Validation in a Greek-speaking population using Rasch analysis

PURPOSE

The Catquest-9SF questionnaire is a tool measuring visual disability and vision-related limitation in patients' daily activities. The primary objective of this study was the validation of Catquest-9SF in a Greek-speaking cataract population.

METHODS

The questionnaire was translated into Greek and translated back into English. A pre-final Greek version was formed and tested by 10 Greek-English bilingual participants and by the translation team, and the final version was produced. Patients scheduled for cataract surgery completed the questionnaire preoperatively and postoperatively. Rasch analysis was performed for the assessment of the Catquest-9SF psychometric properties, including response category ordering, item fit statistics, principal components analysis, precision, differential item functioning and targeting for preoperative and postoperative data collectively.

RESULTS

A total of 100 (55 men, 45 women, mean age = 71.94±6.63) cataract patients completed the Greek version of Catquest-9SF questionnaire preoperatively and postoperatively. Rasch analysis showed a significant improvement in the median person Rasch score from -1.49 preoperatively to -4.71 logits postoperatively, while the effect size was 1.3. Unidimensionality was confirmed since infit and outfit mean square values varied between 0.66 and 1.37. Rasch analysis showed good precision and separation ability (Person Separation Index of 3.28, and Person Reliability of 0.92). Four response categories were found for all items. The item-person means difference was -1.83 logits. The difference between preoperative and postoperative Catquest-9SF logit score was positively correlated with preoperative Catquest-9SF logit score (coeff. = 0.798, p<0.0001) and negatively correlated with postoperative spherical equivalent (coeff. = -0.825, p = 0.011).

CONCLUSION

The Greek version of Catquest-9SF proved to be reliable, valid, unidimensional and responsive to changes after cataract surgery presenting good psychometric properties for cataract patients. Some postoperative mistargeting was found indicating that the tasks were easily performed by respondents after cataract surgery.

TRIAL REGISTRATION

NCT05323526 -retrospectively registered.

Self-assessed visual function outcome in cataract surgery: minimum important difference of the Catquest-9SF questionnaire

BACKGROUND

The purpose of this study was to study the minimum important difference (MID) of the Catquest-9SF questionnaire in cataract surgery.

METHODS

A nationwide multi-center prospective randomized study was conducted using the Swedish National Cataract Register and the Catquest-9SF questionnaire. Randomized patients (n = 400) who had completed the Catquest-9SF before surgery and three months after surgery were sent an anchor question on self-assessed change in visual function after cataract surgery 14 days after the postoperative Catquest-9SF. Rasch analysis was performed on the preoperative and postoperative Catquest-9SF questionnaires, and the patients were dichotomized with regard to their preoperative Rasch score. The MID range of the two groups was calculated based on the anchor question, and the anchor question based MID was then estimated in a scatter plot. The MID was also estimated based on distribution by calculating Cohen's effect size.

RESULTS

The analyses included 231 patients who had completed the Catquest-9SF on both occasions as well as the questionnaire with the anchor question. The group with better preoperative visual function had an anchor question based MID of - 0.5 and a Cohen's effect size based MID of - 1.07. The group with worse preoperative visual function had an anchor question based MID of - 1.80 and a Cohen's effect size based MID of - 1.46.

CONCLUSION

This article contributes detailed knowledge of the MID of Catquest-9SF, enabling even more accurate high-quality evaluation of the outcome and benefit of cataract surgery worldwide.

Predictive accuracy of an intraoperative aberrometry device for a new monofocal intraocular lens

PURPOSE

To evaluate refractive outcomes for the Clareon monofocal intraocular lens (IOL) in terms of achieved target refraction for the ORA (ALCON) intraoperative wavefront aberrometry device and preoperative noncontact biometry.

SETTING

University Eye Clinic Maastricht, Maastricht University Medical Center+, the Netherlands.

DESIGN

Prospective observational clinical trial.

METHODS

Patients with bilateral age-related cataracts undergoing phacoemulsification, either by delayed sequential surgery or on the same day, were included in the study. Exclusion criteria were an increased risk for refractive surprise or complicated surgery. Implanted IOL power was based on noncontact optical biometry data using the Barrett Universal II (BU-II) formula, optimized for the Clareon IOL. Postoperative subjective refraction was measured 4 to 6 weeks after surgery. Catquest-9SF questionnaires were completed preoperatively and 3 months after surgery.

RESULTS

100 eyes (51 patients) were included. The percentages of eyes within 1.0 diopters (D), 0.75 D, 0.50 D, and 0.25 D of target for ORA vs BU-II were 84% (84 eyes), 72% (72 eyes), 57% (57 eyes), and 21% (21 eyes) vs 97% (97 eyes), 88% (88 eyes), 77% (77 eyes), and 53% (53 eyes), respectively. Mean absolute prediction error was significantly higher for ORA vs preoperative biometry (P < .001). After global optimization, the prediction accuracy of ORA improved significantly (P < .001). Catquest-9SF questionnaires showed improved levels of ability at 3 months after surgery (P < .001).

CONCLUSIONS

This study showed lower percentages of eyes within target refraction for ORA (prior to lens constant optimization) compared with the BU-II formula when implanting the Clareon IOL. However, prediction accuracy of ORA improved significantly after global optimization. Therefore, further intraoperative measurements, postoperative measurements, and optimization are needed to improve the ORA prediction for this IOL.

Visual outcomes of a novel non-diffractive extended depth-of-focus IOL targeted for mini-monovision: 3 month results of a prospective cohort study

PURPOSE

Evaluating visual outcomes, spectacle independence, and optical phenomena after bilateral implantation of a non-diffractive extended depth-of-focus (EDOF) IOL targeted for mini-monovision.

SETTING

University Eye Clinic Maastricht, the Netherlands.

DESIGN

Prospective case series.

METHODS

Patients with age-related cataract were bilaterally implanted with a non-diffractive EDOF IOL (Alcon Acrysof IQ Vivity), targeted for mini-monovision. Outcome measures were the uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), distance corrected intermediate visual acuity (DCIVA), distance corrected near visual acuity (DCNVA), refractive outcomes, defocus-curves, spectacle independence, photic phenomena and Catquest-9SF questionnaires.

RESULTS

44 eyes of 22 patients were included. Binocular UDVA, UIVA and UNVA were -0.07 (± 0.10), 0.04 (± 0.09) and 0.23 (± 0.12) logMAR, respectively. The percentage of eyes within 1.0D and 0.5D of target was 100% and 95% for the dominant eye, 100% and 86% for the nondominant eye. The binocular defocus-curve was better than 0.10 logMAR over a range from -2.0D to +0.5D. The percentage of patients who reported no or rarely using glasses for distance, intermediate and near viewing distance was 96%, 68%, 38%, respectively. The percentage of patients who experienced no halos, glare or starbursts were 91%, 91%, 100%, respectively. Catquest-9SF showed a high patient satisfaction for daily life activities.

CONCLUSION

Bilateral Acrysof IQ Vivity IOL implantation targeted for mini-monovision, provides good visual acuity results for far and intermediate with functional near vision, high level of patient satisfaction and spectacle independence, and a monofocal disturbance profile.

Cost analysis of mydriasis strategies in cataract surgery care in the Netherlands

PURPOSE

To investigate the economic impact of an intracameral mydriatics and anesthetic agent (ICMA), topical mydriatics, and a mydriatic ocular insert in cataract patients.

SETTING

One public hospital in the Netherlands.

DESIGN

Prospective cohort study.

METHODS

Resource use data were collected from a healthcare and societal perspective on the day of surgery. Other outcome parameters included pupil size, surgeon satisfaction, postoperative pain, and Catquest-9SF scores.

RESULTS

A total of 368 patients were included, the mean costs per patient were €506 in the ICMA group (n = 122), €474 in the ocular insert group (n = 115), and €451 in the topical group (n = 131). The acquisition cost of ICMA was highest and resulted in longer surgical time. After correction for an imbalance in the distribution of fast and slow surgeons, the mean costs in the ocular insert and topical groups were comparable (€450 vs €444). There was no statistically significant difference in the use of additional mydriatics intraoperatively (P = .521). The mean ratio of pupil size to white-to-white distance was lower in the ICMA group during all intraoperative measurements (P < .001) but similar between the topical and ocular insert groups (P range .11-.82).

CONCLUSIONS

In the investigated setting in the Netherlands, ICMA was the most costly strategy. In addition, pupil size was lowest in the ICMA group but did not result in more additional mydriasis measures intraoperatively. The ocular insert was comparable with topical mydriatics in costs and pupil size. Implementation of ICMA could be considered when availability of nurses or physical space for perioperative care is limited.

Validity of the French version of Catquest-9SF and use of an electronic notepad for entering patient-reported outcome measures

Background

The Catquest-9SF questionnaire is a patient reported outcome measure that quantifies the visual benefits from cataract surgery. The purpose of this study was to translate and adapt the Catquest-9SF questionnaire for France, to assess its psychometric properties via Rasch analysis, and to assess its validity when completed using an electronic notepad.

Methods

The Catquest-9SF questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF and clinical data were collected from patients before and after routine cataract surgery. All questionnaire data were collected via an electronic notepad. Rasch analysis was performed to assess psychometric properties, and sensitivity to change was analysed for patients with complete paired pre- and post-operative questionnaires.

Results

A complete filled-in preoperative questionnaire was obtained for 848 patients. Rasch analysis showed good precision (person separation: 2.32, person reliability: 0.84), ordered category probability curves, no item misfit, and unidimensionality. The respondents were slightly more able than the level of item difficulty (targeting: −1.12 logits). Sensitivity was analysed on 211 paired questionnaires, and the postoperative questionnaires showed a clear ceiling effect. The effect size was 2.6. The use of an electronic notepad for completing the questionnaire worked out very well after some adjustments.

Conclusions

The French version of Catquest-9SF has good psychometric properties and is suitable for use in French-speaking patients. The use of the Catquest-9SF questionnaire in an electronic format showed good validity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40662-021-00233-7.

Patient-reported visual function outcome in cataract surgery: test-retest reliability of the Catquest-9SF questionnaire

PURPOSE

To study the test-retest reliability of the Catquest-9SF questionnaire in cataract surgery.

METHODS

A single-centre prospective non-randomized test-retest study was conducted using the Swedish National Cataract Register and the Catquest-9SF questionnaire, which is a valid patient-reported outcome measurement tool developed and used for evaluating quality and visual disability outcome in cataract surgery. Consecutive patients (n = 144) scheduled for cataract surgery completed the Catquest-9SF twice before surgery, with a minimum of 7 days and a maximum of 14 days between the two questionnaires. A rating scale model was constructed on the basis of the questionnaires from the first measurement and used to generate scores for both the first and second measurements. The consistency was investigated by calculating intraclass correlation, Pearson correlation and a Bland-Altman plot. Internal consistency was measured using Cronbach's alpha.

RESULTS

Analyses showed an intraclass correlation of 0.93 (95% confidence interval: 0.90-0.95), a Pearson correlation of 0.93 and Cronbach's alpha of 0.94. The results fit well in a Bland-Altman plot.

CONCLUSION

The test-retest reliability of the Swedish Catquest-9SF is excellent. Along with previous knowledge, this supports continued use of the Catquest-9SF in evaluating quality and outcome in cataract surgery.

Catquest-9SF questionnaire and eCAPS: Validation in a Canadian population

Background

Visual acuity alone has limitations in assessing a patient’s appropriateness and prioritization for cataract surgery. Several tools, including the Catquest-9SF questionnaire and the electronic cataract appropriateness and priority system (eCAPS) have been developed to evaluate patients–reported visual function as related to day-to-day tasks. The aim of this study was to validate Catquest-9SF and eCAPS in a Canadian population and propose a shorter version of each, in an attempt to extend their applicability in clinical practice.

Methods

The English translation of the Swedish Catquest-9SF and eCAPS were self-administered separately in pre-operative patients in tertiary care in Peel region, Ontario. Rasch analysis was used to validate both scales and assess their psychometric properties, such as category threshold order, item fit, unidimensionality, precision, targeting, and differential item functioning.

Results

A total of 313 cataract patients (mean age = 69.1, 56.5% female) completed the Catquest-9SF and eCAPS. Catquest-9SF had ordered response thresholds, adequate precision (person separation index = 2.09, person reliability = 0.81), unidimensionality and no misfits (infit range 0.75–1.35, outfit range 0.83–1.36). There mean for patients was equal to -1.43 (lower than the mean for items which is set automatically at zero), meaning that tasks were relatively easy for respondent ability. eCAPS had 3 items that misfit the Rasch model and were excluded (infit range 0.82–1.30, outfit range 0.75–1.36). Precision was inadequate (person separation index = 0.19, person reliability = 0.04). 78.8% of subjects scored≤9 (answered that they had no issues for most questions).

Conclusions

Catquest-9SF demonstrated good psychometric properties and is suitable for assessing visual function of care-seeking patients referred for cataract surgery in Ontario, Canada. There was some mistargeting, suggesting that the tasks were relatively easy to perform, which is consistent with previous research. On the contrary, eCAPS is not sensitive in differentiating patients who had impaired visual functioning.

Validation and application of Catquest-9SF in various populations: A systematic review

Cataract is a common cause of reversible blindness. Visual acuity alone is not enough to assess appropriateness for surgery, prioritization, and outcomes. Catquest-9SF questionnaire evaluates patients' self-assessed visual function as related to daily tasks. We summarize and assess the validity of Catquest-9SF as a patient-reported outcome questionnaire to determine its suitability for clinical use. Thirteen studies with sample sizes ranging 102-10,886 (total n = 15,289) undertaken from 2009 to 2018 were included. Catquest-9SF showed unidimensionality, ordered response thresholds, and acceptable precision in all studies. Nine studies had significant mistargeting (range 0.66 to -2.04); the tasks being easy relative to the respondent ability in most studies. Two studies had misfitting items. We conclude Catquest-9SF is a valid and reliable tool to measure visual function in patients with cataract in various populations. Because results can be population specific, it is recommended that Catquest-9SF be validated in a new population before it is incorporated in routine practice.

Validation of Catquest-9SF in Danish: developing a revised form of the Catquest-9SF - the Danish Catquest-7SF

PURPOSE

The primary goal was to validate a Danish translated version of the Catquest-9SF by Rasch analysis. The secondary goal was to investigate whether preoperative Catquest-9SF scores, best-corrected visual acuity, comorbidity, gender, age or corneal astigmatism could predict improvements in subjective outcome.

METHODS

In a prospective trial, 250 patients eligible for cataract surgery were included. Patients filled out the translated Catquest-9SF questionnaire before surgery and again 3 months after surgery. Both preoperative and postoperative questionnaires were included in the Rasch analysis. A multiple reverse stepwise regression model was used to investigate the correlation between preoperative measurements and subjective improvement.

RESULTS

The preliminary Rasch analysis showed misfit of items 4 and 6. These items were removed, and the remaining seven items demonstrated a measurement precision of 2.78, a person reliability coefficient of 0.89, ordered response categories, infit of 0.69-1.22, outfit of 0.73-1.14, observed raw variance explained by measures of 70.4% and an eigenvalue of 1.7. Item 7 showed a mild DIF for gender (0.54 logits), and person mean Rasch score targeting was -1.69 logits. Preoperative Catquest score was the only parameter with a significant correlation to a gain in subjective outcome (p < 0.001). A preoperative Catquest-9SF score of 0.5 carried a 95% likelihood of an increase in subjective outcome.

CONCLUSION

The Danish version of the Catquest-9SF fit the Rasch model. Only preoperative Catquest-9SF score was correlated to subjective improvement, and a cut-off value of 0.5 predicted an improvement in subjective outcome with 95% probability.

Effects of clinical parameters on patient-reported outcome in cataract patients: a multicentre study

PURPOSE

Ophthalmologists tend to evaluate the results of cataract surgery by focusing on the clinical visual and refractive outcomes and the incidence of complications, where patients' main interest might be their ability to perform daily activities. Therefore, there appears to be a need for optimizing effective communication between patients and ophthalmologist about the outcome of cataract surgery. The aim of this multicentre study was to determine the effects of whether the surgery was performed in one or two eyes, ocular comorbidity and per- and postoperative complications on visual function experienced by patients measured with the Catquest-9SF.

METHODS

To measure patient-reported outcomes, Catquest-9SF data were collected between 2014 and 2015 in five Dutch hospitals. Data from 870 pairs of questionnaires - completed before and after cataract surgery - were compared with clinical data. Clinical data, retrieved from patients' medical files, consisted of one or two eye surgery, ocular comorbidity and per- and postoperative complications.

RESULTS

Quality of vision improved more in patients who had surgery in both eyes and had fewer postoperative complications (both p < 0.001). We found a nonsignificant trend that quality of vision was worse when ocular comorbidity was present. No significant effect of peroperative complications was observed.

CONCLUSION

Our results emphasize the added value of the Catquest-9SF as a tool for visual function experienced by patients; the additional information can complement clinical parameters to improve patient-centred approaches in clinical practice.

The Chinese Catquest-9SF: validation and application in community screenings

Background

The purpose of this study was to validate the Chinese Catquest-9SF questionnaire in community screenings and explore the correlation between Catquest-9SF scores and Lens Opacities Classification System (LOCS) III cataract grading.

Methods

This was a prospective questionnaire validation study. The Catquest-9SF questionnaire was translated into Chinese and was completed by 104 Chinese cataract patients who were diagnosed in community screening. Rasch analysis was used to assess its psychometric properties, and Spearman correlation coefficient was employed to determine the correlation between Catquest-9SF scores and LOCS III cataract grading.

Results

The Catquest-9SF questionnaire demonstrated ordered response categories and unidimensionality (item fit statistics range: 0.70–1.35); the PSI and PR of the category probability curves were 2.00 and 0.80, respectively. There was a fair but statistically significant correlation between Catquest-9SF (Q6, Q7, and Q8) and LOCS III scores and a moderate correlation between Q4 in Catquest-9SF and subcapsular components for the better eye (r = − 0.546, p < 0.001).

Conclusion

The Chinese version of Catquest-9SF is a valid and reliable questionnaire in community screenings. Thus, this questionnaire may be expected to be an auxiliary tool for preliminary cataract screening use.

Effect of active evaluation on the detection of negative dysphotopsia after sequential cataract surgery: discrepancy between incidences of unsolicited and solicited complaints

PURPOSE

To evaluate the incidence of negative dysphotopsia after sequential cataract surgery.

METHODS

Retrospective cohort study. The incidence of negative dysphotopsia was assessed by retrospective reviewing of medical records and interviews with patients between 2 and 4 months after sequential cataract surgery. Inclusion criteria were uncomplicated surgery, postoperative corrected distance visual acuity (CDVA) ≥20/25 Snellen and the absence of ocular comorbidity. The majority of intra-ocular lens (IOL) implants were one-piece AcrySof SN60WF (161 eyes). Other IOLs (29 eyes) were toric (SN6AT3-6), spherical (SN60AT), three-piece (MN60MA) and multifocal (ReSTOR SN6AD1, PanOptix TFNT00 and Finevision Micro F trifocal).

RESULTS

The study population was comprised of 95 patients with a mean age of 72 ± 10 years. Unsolicited complaints of negative dysphotopsia were reported by eight patients (8%), and two of them had a resolution of symptoms within 1 month of follow-up. Eighteen patients (19%) reported negative dysphotopsia at the time of the interview. Two patients reported bothersome negative dysphotopsia, and one of them was successfully treated with implantation of a supplementary IOL in the ciliary sulcus. Patients with negative dysphotopsia were younger than patients without dysphotopsia (p = 0.045) and had shorter axial eye length (p = 0.04), a tendency for higher IOL power (p = 0.09) and a higher CDVA (p = 0.001).

CONCLUSION

The incidence of unsolicited negative dysphotopsia after sequential cataract surgery appears to be a substantial underestimation of complaints identified in active interviewing. Although symptoms are not bothersome in the majority of cases, some patients with undiagnosed severe negative dysphotopsia may benefit from reassurance or secondary treatment.