gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Does surgery influence the quality of life in glaucoma patients? : Assessment of quality of life by means of a recently developed specific questionnaire

Meeting Abstract

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  • corresponding author O. Schwenn - Department of Ophthalmology, Bürgerhospital Frankfurt am Main
  • K. Brauer - Department of Medical Biometry, Epidemiology and Informatics, University of Mainz
  • F. Krummenauer - Department of Medical Biometry, Epidemiology and Informatics, University of Mainz

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.02.16

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Veröffentlicht: 22. September 2004

© 2004 Schwenn et al.
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Questionnaires revealed worse scores of health-related quality of life among glaucoma patients (MOS SF-36, NEI-VFQ, VF-14: Gutierrez et al., 1997; MOS SF-36: Wilson et al., 1998). Quality of life findings of newly diagnosed glaucoma patients demonstrated a worsening in 28% of the patients (Perfetti et al., 1998). More than 30% of the patients are afraid of blindness (Odberg et al., 2001). Especially glaucomatous visual field loss as well as deterioration of visual acuity (VAQ: Mills et al., 1998; MOS SF-20, ADVS: Sherwood et al., 1998) and the complexity of treatment regimen (MOS SF-20, ADVS: Sherwood et al., 1998; VFA, EQ-5D: Montemayor et al., 2001) contribute to a worsening of quality of life. After surgical treatment Perfetti found a worsening of quality of life in 16% and an improvement in 52% of the patients. Statistically significant differences between surgical and medical treatment were not observed in the CIGTS (VAQ, SIP: Collaborative Initial Glaucoma Treatment Study, Janz et al., 2001).


A specific questionnaire to evaluate glaucoma patients' assessment of quality of life in German language is not available. Therefore, a questionnaire based on 53 items was designed to assess the following putative determinants of glaucoma-specific quality of life: general health, vision, medical treatment, problems in daily living, traffic, inter-human relationships, hobbies, and emotional life. Feasibility and result plausibility of this proposal were evaluated in glaucoma patients of the University Eye Hospital of Mainz shortly before and four months after glaucoma surgery. Patient rating of the 53 items were assessed by means of a four-valued scale and then averaged along the respective items of the above quality of life determinants. Benefit estimates in terms of scores ranging from 1.0 to 4.0 (optimum rating) were obtained for each putative determinant.


Ratings of 31 patients (median age 68 years, interquartile range 61 - 75 years) could be analyzed, 18 of whom provided information on both pre- and post-surgical assessments. None of the above scores showed clinically relevant changes after surgery: For example, the "medical treatment" score showed a median change from 3.3 (interquartile range 2.7 - 3.7) to 3.3 (2.6 - 4.0), the "hobbies" score rose from 3.5 (2.9 - 3.8) to 3.6 (3.0 - 3.8). An overall score of all 53 items slightly increased from 3.2 (2.6 - 3.7) to 3.3 (2.6 - 3.7) in median. These changes were neither clinically relevant nor statistically significant (p=0.227, p=0.424 and p=0.481 for the above scores, respectively) due to the restrictions in sample size.


After elimination of questions, which were identified redundant, a reduced version of the initial questionnaire, based on 25 questions, can be expected to improve both effectiveness and patient acceptance, and therefore to facilitate routine application.