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LASIK, Patient satisfaction, Quality of life, Questionnaire
Background and aim: Laser-assisted in situ keratomileuses (LASIK) refractive surgery is a cutting-edge and developing area of ophthalmology. Reshaping the cornea during refractive surgery helps patients become less dependent on glasses or contact lenses. The aim of the present study was to evaluate the visual outcome, quality of life, and patient satisfaction following LASIK surgery at a tertiary care center in North India using the National Eye Institute Refractive Error Quality of Life (NEIRQL-42) questionnaire.
Methods: NEI-RQL, a 42-item measure with 13 subscales. The questionnaire was administered to a sample size of 71 patients who underwent LASIK Surgery at a tertiary center in North India. Data were collected pre- and post-surgery (1,3,6 month post-LASIK) for myopic or hyperopic refractive error. Statistical analysis was done using the Friedman test and Wilcoxon signed-rank test.
Results: In myopic patients, the mean preoperative spherical equivalent (SE) was -4.19 ± 2.28D in the right eye and -4.26 ± 2.28D in the left eye and post-op SE -0.06±0.29 (p=0.00). The largest improvements (>25 points) on the 0 to 100 possible score range, were seen in activity limitations, dependence on correction, appearance, and satisfaction with correction subscales. The subscale glare showed a statistically significant difference (worsening) whereas a non-significant change (P> 0.05) was recorded only in the sub-optimal correction sub-scale.
Conclusions: The NEIRQL-42 is a responsive tool to evaluate vision-related changes in quality of life after LASIK surgery in the Indian population. The best surgical expectancy and QoL can be expected at 6 months following surgery.
2. Koch DD, Kohnen T, Obstbaum SA, Rosen ES. Format for reporting refractive surgical data. J Cataract Refract Surg. 1998 Mar 1;24(3):285-7.
3. McGhee CN, Craig JP, Sachdev N, Weed KH, Brown AD. Functional, psychological, and satisfaction outcomes of laser in situ keratomileusis for high myopia. J Cataract Refract Surg. 2000 Apr 1;26(4):497-509.
4. Eydelman M, Hilmantel G, Tarver ME, et al. Symptoms and satisfaction of patients in the patient-reported outcomes with laser in situ keratomileusis (PROWL) studies. JAMA ophthalmol. 2017 Jan 1;135(1):13-22.
5. Hays RD, Mangione CM, Ellwein L, et al. Psychometric properties of the National Eye Institute–refractive error quality of life instrument. Ophthalmol. 2003 Dec 1;110(12):2292-301.
6. Nichols JJ, Twa MD, Mitchell GL. Sensitivity of the National Eye Institute Refractive Error Quality of Life instrument to refractive surgery outcomes. J Cataract Refract Surg. 2005 Dec 1;31(12):2313-8.
7. Patel DB, Patel AM, Shah MA, Vyas AK, Shah S. Functional outcome and patient satisfaction following LASIK surgery. Indian J Clin Expl Ophthalmol. 2018 Oct;4(4):473-7.
8. Bailey MD, Mitchell GL, Dhaliwal DK, Wachler BS, Zadnik K. Patient satisfaction and visual symptoms after laser in situ keratomileusis. Ophthalmology. 2003 Jul 1;110(7):1371-8.
9. Stein JD. Disparities between ophthalmologists and their patients in estimating quality of life. Curr opin ophthalmol. 2004 Jun 1;15(3):238-43.
10. Queirós A, Villa-Collar C, Gutiérrez AR, Jorge J, González-Méijome JM. Quality of life of myopic subjects with different methods of visual correction using the NEI RQL-42 questionnaire. Eye & contact lens. 2012 Mar 1;38(2):116-21.
11. Shams N, Mobaraki H, Kamali M, Jafarzadehpour E. Comparison of quality of life between myopic patients with spectacles and contact lenses, and patients who have undergone refractive surgery. JW Curr Ophthalmol. 2015 Mar 1;27(1-2):32-6.
12. González-Pérez J, García ÁS, Villa-Collar C. Vision-specific quality of life: laser-assisted in situ keratomileusis versus overnight contact lens wear. Eye & contact lens. 2019 Jan 1;45(1):34-9.
13. Sijtsma K. On the Use, the Misuse, and the Very Limited Usefulness of Cronbach's Alpha. Psychometrika. 2009 Mar;74(1):107-120.
14. van Griethuijsen RALF, van Eijck MW, Haste H, et al. Global Patterns in Students’ Views of Science and Interest in Science. Res Sci Educ. 2015;45(4):581-603.
15. Taber, K.S. The use of Cronbach’s Alpha when developing and reporting research instruments in science education. Res Sci Educ 2019;48:1273-1296.
16. Tahzib NG, Bootsma SJ, Eggink FA, Nabar VA, Nuijts RM. Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia. J Cataract Refract Surg. 2005 Oct 1;31(10):1943-51.
17. McDonnell PJ, Mangione C, Lee P, et al. Responsiveness of the National Eye Institute Refractive Error Quality of Life instrument to surgical correction of refractive error. Ophthalmol. 2003 Dec 1;110(12):2302-9.
18. Garamendi E, Pesudovs K, Elliott DB. Changes in quality of life after laser in situ keratomileusis for myopia. J Cataract Refract Surg. 2005 Aug 1;31(8):1537-43.
19. Chen SP, Manche EE. Patient-reported vision-related quality of life after bilateral wavefront-guided laser in situ keratomileusis. J Cataract Refract Surg. 2019 Jun 1;45(6):752-9.
20. Chen CY, Keeffe JE, Garoufalis P, et al. Vision-related quality of life comparison for emmetropes, myopes after refractive surgery, and myopes wearing spectacles or contact lenses. J Refract Surg. 2007 Oct 1;23(8):752-9.
21. Shetty R, D’Souza S, Srivastava S, Ashwini R. Topography-guided custom ablation treatment for treatment of keratoconus. Indian J Ophthalmol. 2013 Aug 1;61(8):445-50.