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Vu Quang Do, Lisa J Keay, Anna Palagyi, Fiona Stapleton, Jan Steen, Andrew JR White, Peter J McCluskey; Predictors of patient satisfaction following cataract surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6231. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The patient’s perspective on vision following cataract surgery is important in defining surgical success, however little is known about the relationship between satisfaction with post-operative vision and preoperative vision status. A prospective cohort study was performed to determine whether preoperative factors were predictive of dissatisfaction with vision following cataract surgery.
Bilateral cataract patients (aged 50 years and older) scheduled for their first-eye cataract surgery were recruited at four metropolitan NSW public hospitals. Patients with significant comorbidities that were considered to impact surgical outcome, such as advanced glaucoma, amblyopia, dementia, stroke or Parkinson’s disease, were excluded. Participants were assessed prior to first-eye surgery and 3-months after surgery. We used logistic regression to investigate the impact of pre-operative visual acuity, contrast sensitivity, stereopsis, spherical ametropia, astigmatism, distance spectacle dependence, residual refractive error, driving status and self-reported visual disability (Catquest 9SF, rescaled 0-100) on dissatisfaction with postoperative vision.
The mean age of participants was 72 ±8 years (mean ± SD), with the majority were female (53%, n=78/147). Mean bilateral visual acuity was 0.24 ±0.2 logMAR (mean ± SD) and median bilateral log contrast sensitivity was 1.56 (IQR: 1.40-1.68) prior to cataract extraction. One in every five participants (n=30) were dissatisfied with their first-eye cataract surgery. Pre-operative patient-reported visual disability (χ2= 8.20, 1 DF, p=0.004) and 2 dioptres of more astigmatism (χ2=4.05, 1 DF, p=0.044) were found to be independently predictive of postoperative vision dissatisfaction. For every 10 units increase in visual disability, the risk of dissatisfaction with postoperative vision increased by 64% (OR=1.64, 95%CI: 1.17 to 2.3). Those with high astigmatism were 2.6 times more likely to be dissatisfied with vision postoperatively (OR=2.6, 95%CI: 1.03 to 6.63).
This study suggests that patients with complex pre-operative refractive errors such as high astigmatism may be more likely to be dissatisfied with their vision post-operatively. Patient-reported visual disability, rather than more commonly used objective measures of vision was associated with post-operative dissatisfaction with vision.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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