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      Successful Cataract Surgery Leads to an Improvement in Depressive Symptomatology

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          Abstract

          Introduction: Cataract is the most common reversible cause of blindness worldwide, and the associated vision impairment has been associated with an adverse impact on health-related quality of life and mental health in particular. However, findings from studies on the mental health improvement of patients after cataract surgery remain inconclusive. The objective of this study is to ascertain whether the outcome on best-corrected visual acuity (BCVA) following cataract surgery is associated with depressive symptomatology. Methods: This is an observational prospective study of a cohort of 150 consecutive patients who underwent phacoemulsification surgery and who were evaluated for changes in depressive symptomatology with Beck’s Depression Inventory-II (BDI-II). Results: The difference in BDI-II scores pre- and postoperatively correlated with the difference in BCVA pre- and postoperatively ( p < 0.001). A paired-samples t test revealed a statistically significant difference in the preoperative and postoperative BDI-II scores ( p < 0.001). A related-samples Wilcoxon signed-rank test revealed a statistically significant improvement of depression status among the patients ( p = 0.004). A stepwise regression analysis concluded that the only statistically significant predictor in assessing the difference in total BDI-II score before and after the operation was the respective difference in visual acuity. Discussion/Conclusion: The success of phacoemulsification surgery for cataract as evaluated with the change in BCVA is related to the rate of improvement in depressive symptomatology.

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          Most cited references 12

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          Psychometric properties of the Beck Depression Inventory II (BDI-II) among community-dwelling older adults.

          The psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-administered screening tool for depressive symptoms were examined in a sample of community-dwelling older and younger adults. Participants completed the BDI-II, the Center for Epidemiologic Studies Depression Scale, the Coolidge Axis II Inventory, the Perceived Stress Scale, and the Short Psychological Well-Being Scale. Internal reliability of the BDI-II was found to be good among older and younger adults. The average BDI-II depression score did not differ between younger and older adults. Solid evidence for convergent and discriminant validity was demonstrated by correlations between the BDI-II with the other measures. The BDI-II appears to have strong psychometric support as a screening measure for depression among older adults in the general population. Implications for using the BDI-II as an assessment instrument in behaviorally based psychotherapy are discussed.
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            The impact of cataract surgery on cognitive impairment and depressive mental status in elderly patients.

            To evaluate the influence of cataract surgery on cognitive function and depressive mental status of elderly patients. Prospective, interventional case series. The 25-Item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), Mini-Mental State Examination (MMSE), and Beck Depression Inventory (BDI) are the measures designed to assess vision-related quality of life (QOL), cognitive impairment, and depressive mental status, respectively. These tests were performed before and two months after surgery in 102 patients undergoing phacoemulsification and intraocular lens implantation for bilateral cataract. The change in best-corrected visual acuity by surgery significantly correlated with the change in NEI VFQ-25 score (Pearson correlation, r = -0.310; P = .031). The change in NEI VFQ-25 score by surgery significantly correlated with the change in MMSE score (r = 0.306; P = .035) and the change in BDI score (r = -0.414; P < .001). The change in MMSE score showed significant correlation with the change in BDI score (r = -0.434; P < .001). Vision-related QOL, cognitive impairment, and depressive mental status are all strongly related with each other. Cataract surgery significantly improved vision-related QOL in elderly patients, and cognitive impairment and depressive mental status also improved in parallel with improvement in vision-related QOL.
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              Impact of cataract surgery on health-related quality of life in nursing home residents.

              To assess the impact of cataract surgery in nursing home residents on health-related quality of life, as compared to those who have cataracts but who do not undergo surgery. A prospective cohort study enrolled 30 nursing home residents (>or=60 years old) who had cataracts and underwent cataract surgery, and evaluated vision-targeted and generic health-related quality of life and depressive symptoms before and approximately 4 months after surgery. This cataract surgery group was compared to 15 nursing home residents who had cataracts but who did not have surgery, over the same timeframe. Visual acuity for near and distance and contrast sensitivity improved following cataract surgery (p<0.001). Adjusting for age differences in the two groups, the cataract surgery group exhibited significant score improvement in the general vision (p = 0.005), reading (p = 0.001), psychological distress (p = 0.015), and social interaction (p = 0.033) subscales of the Nursing Home Vision-targeted Health-Related Quality of Life Questionnaire and the VF-14 (p = 0.004). There were no group differences in the SF-36, Geriatric Depression Scale or the Cataract Symptom Score. Nursing home residents who underwent cataract surgery because of functional problems experienced significant improvements in their vision-targeted health-related quality of life, in addition to dramatically improved vision.
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                Author and article information

                Journal
                ORE
                Ophthalmic Res
                10.1159/issn.0030-3747
                Ophthalmic Research
                S. Karger AG
                0030-3747
                1423-0259
                2021
                February 2021
                26 May 2020
                : 64
                : 1
                : 50-54
                Affiliations
                a2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
                bDepartment of Business Administration, University of Macedonia, Thessaloniki, Greece
                Author notes
                *Ioanna Mylona, 2nd Department of Ophthalmology, Papageorgiou General Hospital, Agiou Pavlou 76, Pavlos Melas, GR–564 29 Thessaloniki (Greece), milona_ioanna@windowslive.com
                Article
                508954 Ophthalmic Res 2021;64:50–54
                10.1159/000508954
                32454493
                © 2020 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 2, Pages: 5
                Categories
                Research Article

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