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[Predictors of quality of life in refractive surgery].

PURPOSE
To investigate predictors of quality of life in refractive surgery: psychological status, quality of vision, visual acuity, and patient satisfaction.


METHODS
In a prospective study, 143 patients were evaluated preoperatively and after the third postoperative month using the same questionnaire. Quality of vision, visual acuity, well-being, self-esteem, coping, and patient satisfaction were analyzed with 47 parameters. Refractive procedures included PRK, LASIK, and phakic IOL. Four groups of low (G1), medium (G2), and high myopia (G3) and hyperopia (G4) were individualized to compare the results.


RESULTS
We noted a mean postoperative best corrected visual acuity (BCVA) of 20/25 or more for the G1, G2, and G4 groups. For the G3 group, the mean BCVA was increased, with a gain of two Snellen Lines from 20/50 to 20/32. Postoperative patient satisfaction improved, with a significant difference (p<0.05) in all groups. We noted no significant difference in all myopic groups in well-being and no significant decrease in G4. Concerning self-esteem and coping, scores improved, with a significant difference in G3 group (p<0.05). Quality of vision was directly correlated with improvement of quality of life (psychological status), satisfaction scores, and BCVA preoperatively and postoperatively in all patients, but no correlation was noted between visual acuity and patient satisfaction.


CONCLUSION
In spite of good refractive results, modification of patient satisfaction depends on quality of vision and quality of life (psychological status) scores. These results give us a new tool that provides useful additional information in refractive surgery.