Patients’ Expectations in Lens Extraction Surgery: a Systematic Review

Abstract

A B ST R AC T It is common knowledge that there are patients who have an uncomplicated cataract surgery with an actual improvement of their visual acuity, but they are dissatisfied with their final visual capacity. It is hypothesized that patients' preoperative expectations play a significant role in their postoperative perceptions. A systematic review of the recent literature regarding preoperative expectations of patients before lens extraction surgery and their postoperative perceptions as regards the visual outcome was performed based on the PubMed, Medline, Google Scholar, American Academy of Ophthalmology, Nature and Springer databases in September 2017 and data from 14 descriptive and 7 comparative studies were included in this narrative review. The objective of this review is the determination of the relationship between preoperative expectations and postoperative perception of visual outcome, as well as the investigation of predictors of patient satisfaction by understanding the factors that determine preoperative patient expectations. A considerable number of studies evaluate patient expectations before cataract surgery and compare them with postoperative patient perceptions. In conclusion, the final patient's postoperative perception could be affected both by the actual outcome of the operation and by patient preoperative expectations. Ocular and systemic comorbidity, unrealistic expectations, preoperative spectacle independence, the cost of surgery, and a previous cataract surgery as well as the level of health literacy and age could influence preoperative expectations and predict more accurately patient satisfaction. Taking these factors into consideration could allow surgeons to control the expectations with an extensive preoperative counseling.

<p>Comparison of Subjective Preoperative Experiences of Patients Before First- or Second-Eye Cataract Surgeries</p>

“…Cataracts are the leading cause of blindness worldwide, and their surgical removal is currently the most frequently performed surgical procedure. 1 This surgery takes place under topical anesthesia, and surgeons are able to communicate with patients throughout the procedure. Thus, patients are conscious, awake, and fully involved in the surgery.…”

Subjective Opinions of Patients About Step-by-Step Cataract Surgery Preparation

“… 32–34 , 36 Similarly, male patients were satisfied with the outcomes of the procedure slightly more often than women. 26 , 35 Finally, according to Nijkamp et al, 36 a higher education level was associated with more realistic expectations with regard to the phacoemulsification outcome.…”

“…Patients operated for cataract usually expect that the surgery will enable them to achieve spectacle independence and normalization of visual acuity. 26–34 Commonly, and most persons subjected to cataract surgeries are highly satisfied with the outcomes. 27 , 30 , 31 , 34 , 35 However, persons with higher preoperative expectations were shown to present with lower levels of postoperative satisfaction.…”

Pseudophakic Approaches for Addressing Presbyopia

“…One cause might be insufficient communication between the patient and ophthalmologist prior to surgery in order to correct false high expectations [43]. During the preoperative visit, it is critical to explore the patient's expectations and motivations concerning refractive surgery and the postoperative outcomes [44]. Factors such as ocular and systemic comorbidities, unrealistic expectations, preoperative spectacle independence, cost of surgery, previous cataract surgery, as well as the level of health, literacy, and age could influence the preoperative expectations and predict more accurately patient satisfaction.…”

“…Factors such as ocular and systemic comorbidities, unrealistic expectations, preoperative spectacle independence, cost of surgery, previous cataract surgery, as well as the level of health, literacy, and age could influence the preoperative expectations and predict more accurately patient satisfaction. Thus, taking those factors into account together with comprehensive preoperative counseling with the patient could allow the surgeon to better control expectations [44].…”