Assessing the Value of Laser in situ Keratomileusis by Patient-reported Outcomes Using Quality of Life Assessment

Abstract

PURPOSE: To assess the value of laser in situ keratomileusis (LASIK) by patient-reported outcomes using quality of life assessment. METHOD: This study included 288 consecutive patients treated by LASIK between July and December 2001 at two eye clinics. A Myopia-specific Quality of Life Questionnaire was developed in this study. The baseline quality of life corresponding to the situation where refractive error was corrected by glasses or contact lenses before LASIK treatment was evaluated by self-administered questionnaire. The evaluation was repeated at 4 days, and 1, 3, and 6 months after LASIK treatment. All question items were rated on a scale ranging from 1 (maximal dysfunction) to 5 (minimal dysfunction). RESULTS: Factor analysis identified 34 questions in 4 subscales-visual function, visual symptoms, social role function, and psychological well-being. The Myopia-specific Quality of Life Questionnaire subscales proved to be internally consistent (Cronbach alpha = 0.70-0.95). Criterion validity was assessed by evaluating Spearman correlation between the overall or domain-specific quality of life and traditional measures of patient status. Overall Myopia-specific Quality of Life Questionnaire score changed from 3.21 preoperatively to 3.76, 4.00, 4.07, and 4.11 at 4 days, and 1, 3, and 6 months after surgery, respectively. Social role function showed the biggest improvement (score change: 1.51, P < .05), followed by psychological well-being (0.90, P < .05), visual function (0.72, P < .05), and visual symptoms (0.49, P < .05). Regression analysis results showed that the degree of uncorrected visual acuity, discomfort associated with myopia preoperatively, and location of eye center were significant factors affecting the magnitude of changes in quality of life after LASIK. CONCLUSIONS: This study confirms that the value of LASIK went beyond the clinical achievement of refractive correction and extended to the improvement of quality of life.