Abstract / Summary
Cataract is associated with reduced ability to perform everyday tasks, loss of independence, and diminished social participation. Clinical measures such as visual acuity do not capture the functional and psychosocial consequences of cataract. Vision-related quality of life (VRQoL) therefore provides an important patient-centred outcome. This study aimed to assess changes in VRQoL after cataract surgery and to identify factors associated with baseline VRQoL in older adults with cataract. This longitudinal pre-post study was conducted on 350 older adults (≥ 60 years) diagnosed with cataract and candidates for surgery at Kashan Eye and Ear Specialty Hospital (October 2024– September 2025). Participants were recruited using consecutive sampling. Data were collected using a demographic questionnaire and the Persian Catquest-9SF at pre-surgery, 2 weeks post-surgery, and 6 months post-surgery. Statistical analyses included descriptive statistics, t-tests, ANOVA, Pearson correlation, paired t-tests, and multiple linear regression. The regression model used baseline (pre-operative) VRQoL as the dependent variable. The mean age was 66.1 ± 6.1 years. The mean VRQoL score increased from 22.18 ± 3.96 before surgery to 28.29 ± 3.95 at 2 weeks and 29.54 ± 3.47at 6 months after surgery ( P < 0.001). In the multivariable regression of baseline VRQoL, older age (β = −0.18, P = 0.002) was negatively associated with baseline VRQoL. In contrast, history of previous cataract surgery (β = 0.17, P = 0.005) and owned-house residence (β = 0.12, P = 0.032) were positively associated with baseline VRQoL. Comorbid diabetes and hypertension (β = −0.23, P < 0.001) and combined use of glasses (β = −0.16, P = 0.006) were also negatively associated with baseline VRQoL. These variables explained 16.0% of the variance. VRQoL improved substantially after cataract surgery in this single-arm pre-post cohort, although causality cannot be established without a non-surgical control group. The regression findings concern baseline VRQoL only and should not be interpreted as factors associated with post-operative VRQoL or the magnitude of change. Older age was associated with lower baseline VRQoL, whereas previous cataract surgery and home ownership were associated with higher baseline VRQoL. Comorbid diabetes and hypertension and combined use of glasses were also associated with lower baseline VRQoL.