Qualité de vie après Lasik : partie I. Validation de la traduction française de l’échelle NEI-RQL-42

Cross-validation of the Tunisian version of the National Eye Institute Visual Function Questionnaire 25

INTRODUCTION

The goal of our study was to create a cross-cultural adaptation of the questionnaire « National Eye Institute Visual Function Questionnaire » (NEI-VFQ-25) for the Tunisian population (Tu-VFQ-25) and to test its psychometric properties in a group of patients with chronic uveitis.

PATIENTS AND METHODS

The study consisted of two steps. The first was translation of the NEI-VFQ-25 and its cross-cultural adaptation to the Tunisian dialect (Tu-VFQ-25) according to the guidelines of Beaton et al. The second step consisted of studying the psychometric properties of the Tu-VFQ-25. Enrolled patients, diagnosed with chronic uveitis, were interviewed face-to-face by two different investigators, followed by a telephone interview by the first investigator 48hours later. Feasibility, internal consistency and reproducibility of the Tu-VFQ-25 were then tested using statistical methods.

RESULTS

The mean time taken to administrate the questionnaire to each of the 45 patients was 11min 40 s (± 2min 24 s). Internal consistency was acceptable, with Cronbach's alpha coefficients above 0.7 except the "Ocular Pain" and "Driving" subscales (0.645 and 0.559 respectively). Inter-observer reliability was excellent, with intra-class correlation coefficients (ICC) ranging from 0.857 to 0.985 for all subscales. Test-retest reliability, assessed for 43 patients, was good to excellent, with ICC above 0.80 for all subscales except "General Vision," which had a value of 0.786.

CONCLUSION

As with previous versions, the Tu-VFQ-25 is an easy and reliable tool for assessing vision-related quality of life of Tunisian patients with chronic uveitis.

Vision-Specific Quality of Life: Laser-Assisted in situ Keratomileusis Versus Overnight Contact Lens Wear

OBJECTIVES

To compare the visual-related quality of life in myopic subjects with different refractive treatments such as continuous wear of silicone-hydrogel contact lenses (CL), corneal refractive therapy (CRT), and laser-assisted in situ keratomileusis (LASIK).

METHODS

The National Eye Institute Refractive Error Quality of Life Instrument (NEI RQL-42) questionnaire was administered to 96 subjects with a mean age of 30.0±7.9 years. There were 72 myopic subjects with a mean spherical equivalent of -2.74±0.98 D (-5.50 to -1.25 D). Subjects were corrected with LASIK (n=24), Paragon CRT orthokeratology lenses (n=24), and lotrafilcon A silicone-hydrogel CL under continuous wear (n=24). The NEI RQL-42 survey was used to compare differences between groups as well as with an emmetropic group (n=24).

RESULTS

After 1 year of treatment, significant differences were found among all groups in the subscales glare (P=0.017), symptoms (P=0.016), dependence on correction (P<0.001), and worry (P<0.001). The mean difference compared with emmetropes were -5.5% (P=0.063) for LASIK patients, -2.0% (P=0.212) for orthokeratology subjects, and +1.6% (P=0.934) for the silicone-hydrogel CL group.

CONCLUSIONS

Myopic subjects analyzed in this study reported better vision-related quality of life when they were corrected with continuous wear silicone-hydrogel lenses. The average score reached by CRT was similar to emmetropes, which showed the main disadvantage in worry subscale. The patients who underwent LASIK had the lowest valuation, highlighting the decreases in scores of diurnal fluctuations, glare, and especially in expectations and worry subscales, due to the first and second subscales, but especially to the false expectations created about treatment.

[Evaluation of vision quality after laser vision correction in healthcare professionals]

PURPOSE

Healthcare professionals require good quality of vision. The main objective of this study is to evaluate the satisfaction and vision quality after laser vision correction in healthcare professionals.

METHODS

This is a monocentric retrospective study. An online 25-question survey was sent to ametropic physicians, surgeons and nurses who underwent corneal refractive surgery with laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between July 2012 and February 2016. Questionnaire responses were recorded anonymously by the internet survey site. These patients' pre- and postoperative data were analyzed.

RESULTS

In total, 2491 laser vision corrections were performed during this time frame. One hundred and fifty-eight patients were healthcare providers; 131 received the survey, and 111 responded. Ninety-nine were surgeons, 60 were medical physicians, and 32 were nurses. Ninety-one percent reported that they were satisfied with their postoperative vision quality, 63.9% even reported an improvement in their quality of vision compared with their corrected preoperative vision, 92.8% reported that they would have the procedure again, and 94.6% would recommend the procedure to a family member or a patient. Visual outcomes showed high levels of efficacy and predictability.

CONCLUSION

While healthcare professionals require good quality of vision, those who had undergone laser vision correction reported the same satisfaction as the general population and would recommend the procedure to their family, friends and patients.

Psychometric properties of the national eye institute refractive error correction quality-of-life questionnaire among Iranian patients

BACKGROUND AND AIM

To evaluate the psychometric properties of the national Eye Institute refractive error correction quality of life questionnaire (NEI-RQL-42) among Iranian patients with refractive errors.

MATERIALS AND METHODS

Two samples of patients (n1 = 296, n2 = 95) were consecutively selected from the eye clinic of the Boo-Ali Hospital, Qazvin. A forward-backward procedure was conducted to translate and cross-culturally adapt the Iranian version of the NEI-RQL-42. A homogeneity, stability, and reliability test was conducted for the first sample after a two-week interval. Convergent validity was computed using the correlation between the NEI-RQL-42 subscale scores, National Eye Institute-Visual Functioning Questionnaire (NEI-VFQ-25), and the Short Form-36 (SF-36). Furthermore, Known-group analysis was performed, to determine the discriminant validity between the subgroups of patients with hyperopia, emmetropia, and myopia. Responsiveness to clinical change was tested by administering NEI-RQL-42 on the second sample that was scheduled for surgery.

RESULTS

Homogeneity was satisfactory with the Cronbach's alpha coefficients ranging between 0.70 and 0.92. The 13 subscales of the NEI-RQL-42 showed a considerable stability in intra-class-correlation (ICC) ranging between 0.70 and 0.89. Positive correlation coefficients were found among all subscales of the NEI-RQL-42 and the other quality-of-life instruments (NEI-VFQ-25 and SF-36). The NEI-VFQ-25 displayed excellent discriminant validity to differentiate the subgroups of patients, and was found to be responsive to change after the surgical correction at three months.

CONCLUSIONS

The Iranian version of the NEI-RQL-42 is a valid and reliable instrument to assess refractive error correction quality-of-life in Iranian patients. Moreover this questionnaire can be used to evaluate the effectiveness of interventions in patients with refractive errors.