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K.–M.A. Tuan; Gender and Other Factors That Affect Questionnaire Response: An Analysis of Wavefront Guided LASIK Outcomes . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4383.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the results of clinical vision tests with patient perception of vision following wavefront–guided LASIK, and to determine how closely and under what circumstances perception correlated with test results. Methods: Wavefront–guided LASIK was performed on myopic–astigmatic eyes at 6 clinical sites. Questionnaires were administered and comprehensive vision evaluations were conducted before and 6 months after surgery. Questionnaire responses were compared with test results using ordinal logistic regression. Results: Two hundred seventy–four eyes completed 6 months of follow–up. After surgery, the "very satisfied" responses increased in all areas by as much as 70%. Improved visual performance was consistently reflected both perceptually and in test scores. However, patients were more vocal if they experienced decreases in vision. Pre–op magnitude of myopia had minimal influence on questionnaire outcome (p>0.05), but post–op refractive error was a significant predictor for the majority of the questionnaire items (p<0.01 or 0.05). Day vision experience, i.e., sharpness, and daily visual fluctuation, was influenced by uncorrected visual acuity and post–op Rx (p<0.01 or 0.05). Night vision experience was influenced by post–op Rx and mesopic glare contrast sensitivity (CS) (p<0.01). Additionally, the perception of changes in vision seems to be related to mesopic CS and mesopic CS under glare (p<0.01 or 0.05). Mesopic pupil diameter was not a major predictor of visual experience (p>0.05). Male patients were more likely to report frequent visual symptoms and voiced stronger complaints regarding night vision (p<0.01). However, according to their questionnaire scores, the changes in the male subjects’ vision were the same as the changes in their female counterparts. In addition, subjects who used contact lenses prior to surgery were more satisfied with their post–operative vision than subjects who had worn spectacles (p<0.05). Conclusions: Results suggest that in addition to objective visual outcomes, subjective factors affect questionnaire responses. Patients who experienced visual degradation were more expressive of their displeasure. In addition, the patient’s sex and the type of corrective lens used before surgery may be factors in subjective responses. Night vision complaints were corroborated by mesopic contrast testing and post–operative refractive error. Undesirable visual experiences could be reduced and patient satisfaction maximized if post–operative refractive error can be minimized and the overall optical quality of the eyes improved.
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