BEYOND VISION RESTORATION: IMPACT OF CATARACT SURGERY ON PSYCHOLOGICAL WELL-BEING, QUALITY OF LIFE, AND EMOTIONAL HEALTH AMONG OLDER ADULTS

Abstract

Background: Cataract surgery is traditionally evaluated through clinical visual outcomes, yet its broader psychosocial impact remains under-researched in Pakistan. This study evaluated the impact of cataract surgery on quality of life (QoL), depression, and anxiety among older adults in Islamabad, shifting the evaluative lens toward holistic patient-reported outcomes.

Methods: A prospective longitudinal study was conducted among 325 older adults (mean age = 68.4 ± 6.2 years) undergoing uncomplicated phacoemulsification at tertiary care hospitals in Islamabad. Participants were assessed pre-operatively and at a 3-month post-operative follow-up using the WHOQOL-OLD, GDS-15, and GAD-7 scales. Prior to parametric testing, data normalization (skewness/kurtosis within ±2.0) and internal consistency (Cronbach’s α > 0.70) were verified. Paired t-tests, Chi-square analyses, and multiple linear regression were utilized for inferential statistics.

Results: All instruments demonstrated excellent reliability (Cronbach’s α = 0.82–0.88). Post-operative assessments revealed significant improvements across all psychosocial metrics. Mean WHOQOL-OLD scores increased significantly from 54.2 to 72.6 (p < .001). Depressive symptoms (GDS-15) decreased from the mild-to-moderate range (8.6) to normal levels (3.9) (p < .001), and anxiety (GAD-7) dropped from 9.4 to 4.2 (p < .001). Age-stratified analysis indicated the highest frequency of emotional improvement in the 60–69 age group (83.8%) compared to those aged ≥80 years (63.1%). Regression analysis identified younger age and joint-family living arrangements as significant positive predictors of QoL improvement.

Conclusion: Cataract surgery yields profound psychosocial benefits beyond visual restoration, significantly enhancing QoL and remitting depression and anxiety in older adults. Integrating routine psychosocial screening into ophthalmic care pathways and prioritizing earlier surgical intervention—particularly for the oldest-old and those lacking robust family support—are recommended to maximize holistic health outcomes.