Vision-Targeted Health-Related Quality-of-Life Survey for Evaluating Minimally Invasive Glaucoma Surgery

Qi N Cui; Ron D Hays; Michelle E Tarver; George L Spaeth; Sylvia H Paz; Beverly Weidmer; Ronald L Fellman; Steven D Vold; Malvina Eydelman; Kuldev Singh

doi:10.1016/j.ajo.2021.03.064

Vision-Targeted Health-Related Quality-of-Life Survey for Evaluating Minimally Invasive Glaucoma Surgery

Am J Ophthalmol. 2021 Sep:229:145-151. doi: 10.1016/j.ajo.2021.03.064. Epub 2021 Apr 11.

Authors

Affiliations

¹ From the Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: qi.cui@pennmedicine.upenn.edu.
² Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA; RAND Corporation, Santa Monica, California, USA.
³ Office of Strategic Partnerships and Technology Innovation, Center for Devices and Radiological Health, U.S. Food and Drug Administration, White Oak, Maryland, USA.
⁴ Wills Eye Hospital, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
⁵ Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA.
⁶ RAND Corporation, Santa Monica, California, USA.
⁷ Glaucoma Associates of Texas, Dallas, Texas, USA.
⁸ Vold Vision, Fayetteville, Arkansas, USA.
⁹ Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices, Center for Devices and Radiological Health United States Food and Drug Administration, White Oak, Maryland, USA.
¹⁰ Stanford University School of Medicine, Stanford, California, USA.

Abstract

Purpose: To develop a vision-targeted health-related quality-of-life instrument for patients with glaucoma who are candidates for minimally invasive glaucoma surgery (MIGS).

Design: Development of a health-related quality-of-life instrument.

Participants: Twelve practicing ophthalmologists and 41 glaucoma patients.

Methods: A questionnaire was constructed to assess functional limitations, vision-related symptoms, aesthetics, psychosocial issues, and surgical satisfaction for MIGS candidates. Questions were drafted after a review of the literature and subsequently refined based upon input from 1 physician and 4 patient focus groups. Nineteen cognitive interviews were used to ensure that questions were understandable to respondents.

Results: The focus group identified the following key issues and concerns as being important to glaucoma patients: functional limitations (eg, driving), bodily discomfort (eg, stinging from drops), changes in appearance (eg, drooping eyelid), and psychosocial concerns (eg, mental burden associated with a diagnosis of glaucoma, financial burden of treatment). Cognitive interviews resulted in the following improvements to the questionnaire: changes in wording to clarify lighting conditions, and additional questions addressing psychosocial issues, such as job loss, severity of disease, and perception of MIGS.

Conclusions: A patient-reported outcomes instrument, the Glaucoma Outcomes Survey, was developed to evaluate MIGS for patients with mild to moderate glaucoma. Next steps include electronic administration to patients selected from the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) registry. An electronic patient-reported outcomes platform will be used to administer the questionnaire before and after MIGS. The questionnaire will improve understanding of how surgical interventions such as MIGS impact vision-targeted health-related quality-of-life in glaucoma patients.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review

MeSH terms

Glaucoma* / surgery
Humans
Intraocular Pressure
Minimally Invasive Surgical Procedures
Quality of Life*
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding