Role of the treating surgeon in the consent process for elective refractive surgery

Schallhorn, Steven C.; Hannan, Stephen J.; Teenan, David; Schallhorn, Julie M.

doi:10.2147/opth.s120345

Cited by 3 publications

(7 citation statements)

References 34 publications

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“…Similar to our previous publication,8 we found that the major factor leading to dissatisfaction with consent quality is not the actual consent type, but an unsatisfactory outcome. The major factor affecting perception of consent quality was the satisfaction with postoperative vision, and it was responsible for 80.4% of the variance explained by our multivariate model.…”

Section: Discussionsupporting

confidence: 89%

“…Another advantage of using a 1-month postoperative questionnaire is that patients already experience outcomes of their procedure, but still have some recollection of their preoperative consent information. The questionnaire we used in our study has been previously successfully used in many large population studies 8,36–38. Another possible limitation of the study is the bias in patient’s selection of consent type.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperatively, patients were scheduled for 1-day, 1-week, and 1-month follow-up visits were they were clinically examined and completed a postoperative questionnaire. The methodology of obtaining the questionnaire has been previously described 8. The questionnaire was strictly confidential, and patients were informed that their responses were not made available to the treating surgeon and were not accessible to any clinic personnel.…”

Section: Methodsmentioning

confidence: 99%

“…The model was developed using a stepwise generalized linear approach. Detailed steps in model creation have been previously described 8…”

Section: Methodsmentioning

confidence: 99%

“…In one of our previous publications, we discussed the consent process for elective refractive surgery, the role of the treating surgeon in the consenting process, and examined if meeting the surgeon prior to the surgery or on the day of surgery affects the patient’s perception of consent quality 8. We also explored how the consent process can be enhanced with the use of different tools such as video consent, written information, and the involvement of medical personnel other than the treating surgeon 8. Since our last publication, new UK General Medical Council guidelines were published and came into effect in June 2016.…”

Section: Introductionmentioning

confidence: 99%

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Informed consent in refractive surgery: in-person vs telemedicine approach

Schallhorn

Hannan²,

Teenan³

et al. 2018

OPTH

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PurposeThe aim of this study was to compare the quality of consent process in refractive surgery between patients who had a preoperative consent discussion with the surgeon using a telemedicine approach and those who had a face-to-face discussion.MethodsPatients treated between January and December 2017 (8,184 laser vision correction [LVC] and 3,754 refractive lens exchange [RLE] patients) that attended day 1 and 1-month postoperative visit were retrospectively reviewed. Preoperative consent preparation included a consultation with an optometrist, observation of an educational video, and written information. Patients then selected either a face-to-face appointment with their surgeon (in-clinic group) or a telemedicine appointment (remote group) for their consent discussion, according to their preference. Patient experience questionnaire and clinical data were included in a multivariate model to explore factors associated with consent quality.ResultsPrior to surgery, 80.1% of LVC and 47.9% of RLE patients selected remote consent. Of all LVC patients, 97.5% of in-clinic and 98.3% of remote patients responded that they were adequately consented for surgery (P=0.04). Similar percentages in the RLE group were 97.6% for in-clinic and 97.9% for remote patients (P=0.47). In a multivariate model, the major predictor of patient’s satisfaction with the consent process was postoperative satisfaction with visual acuity, responsible for 80.4% of variance explained by the model. Other significant contributors were postoperative visual phenomena and dry eyes, difficulty with night driving, close-up and distance vision, postoperative uncorrected distance visual acuity, change in corrected distance visual acuity, and satisfaction with the surgeon’s approach. The type of consent (remote or in-clinic) had no impact on patient’s perception of consent quality in the regression model.ConclusionThe majority of patients opted for telemedicine-assisted consent. Those who chose it were equally satisfied as those who had a face-to-face meeting with their surgeon. Dissatisfaction with surgical outcome was the major factor affecting patient’s perception of consent quality, regardless of the method of their consent.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The model was developed using a stepwise generalized linear approach. Detailed steps in model creation have been previously described 8…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Informed consent in refractive surgery: in-person vs telemedicine approach

Schallhorn

Hannan²,

Teenan³

et al. 2018

OPTH

Self Cite

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Outcomes of a Refractive Segmented Bifocal Intraocular Lens with a Lower Near Addition

Venter¹,

Collins²,

Hannan³

et al. 2022

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Purpose To evaluate clinical and subjective outcomes of a segmented bifocal IOL with a 2.0 D near addition. Patients and Methods Retrospective analyses of patients who had undergone refractive lens exchange with bilateral implantation of the SBL-2 IOL (Lenstec, Inc., Christ Church, Barbados) were performed. The number of patients included in the study was 389 (778 eyes). Refractive, visual and patient-reported outcomes were presented for the last available visit (mean follow-up 2.05 ± 1.33 months). Results The percentage of eyes within ±0.50D and ±1.00D of emmetropia was 82.5% (642/778) and 97.8% (761/778), respectively. The mean uncorrected intermediate visual acuity (66 cm) of the last available visit was 0.08 ± 0.15 logMAR monocularly and 0.04 ± 0.14 logMAR binocularly. The mean monocular and binocular uncorrected near visual acuity (40 cm) were 0.30 ± 0.15 logMAR and 0.24 ± 0.14 logMAR, respectively. Of all patients, 97.2% (378/389) claimed never to use any correction for distance vision, while 93.1% (362/389) of patients did not require any correction for near vision. The mean scores for visual phenomena (on the scale from 1 – no difficulty to 7 – severe difficulty) were 1.8 ± 1.3, 1.7 ± 1.2, 1.7 ± 1.2 and 1.6 ± 1.2 for glare, halo, starburst, and ghosting/double vision, respectively. Conclusion Despite the lower near addition of SBL-2 segmented bifocal IOL, patients achieved reasonable rates of spectacle independence and a low incidence of visual phenomena.

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Predictors of Patient Satisfaction After Refractive Lens Exchange With an Extended Depth of Focus IOL

Schallhorn¹,

Hettinger²,

Teenan³

et al. 2020

J Refract Surg

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PURPOSE: To identify independent factors associated with postoperative satisfaction after refractive lens exchange with an extended depth of focus intraocular lens (EDOF IOL). METHODS: Patients who underwent a refractive lens exchange with bilateral implantation of the AT LARA 829MP IOL (Carl Zeiss Meditec, Jena, Germany) and attended the 3-month follow-up visit were included in the analysis (N = 351 patients). Demographics, preoperative and postoperative clinical parameters, and patient-reported outcomes were used in a regression model to determine predictors of 3-month postoperative satisfaction. RESULTS: The mean age of the study group was 58.2 ± 7.0 years (range: 45 to 79 years) and the mean preoperative sphere ranged between −12.50 and +6.75 diopters (D). At 3 months postoperatively, 86.6% of patients were very satisfied or satisfied with outcomes and 93.2% would recommend the procedure to their family or friends. Of all patients, 90.6% achieved binocular uncorrected distance visual acuity of 20/20 or better, 92.0% achieved binocular near vision of 20/50 or better, and 85.5% of eyes were within ±0.50 D of emmetropia. Logistic regression identified postoperative dry eye symptoms, binocular near and distance visual acuity, and glare symptoms as significant independent factors affecting patient satisfaction. CONCLUSIONS: Several factors were independently predictive of postoperative satisfaction after EDOF IOL implantation and addressing these may further improve patient satisfaction with the procedure, specifically, proper management of early symptoms of dry eye, ensuring good refractive predictability to maximize unaided vision, and counseling patients about the possibility of visual phenomena in the early postoperative period. [ J Refract Surg . 2020;36(3):175–184.]

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Role of the treating surgeon in the consent process for elective refractive surgery

Cited by 3 publications

References 34 publications

Informed consent in refractive surgery: in-person vs telemedicine approach

Informed consent in refractive surgery: in-person vs telemedicine approach

Outcomes of a Refractive Segmented Bifocal Intraocular Lens with a Lower Near Addition

Predictors of Patient Satisfaction After Refractive Lens Exchange With an Extended Depth of Focus IOL

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