Versorgungsforschung in der Kataraktchirurgie – eine Analyse der Patientenzufriedenheit nach Kataraktchirurgie in Mecklenburg-Vorpommern

Abstract

The collection of pre-, peri- and postoperative data took place between 2005 and 2008, based on a contract between the social insurance company, AOK Mecklenburg-Vorpommern, and the outpatient cataract surgeons/centers in Mecklenburg-Vorpommern, Germany. The purpose of the contract was the monitoring of quality of cataract surgery in the outpatient healthcare system. We analysed 2952 datasets of 2952 eyes, remaining after exclusion of 109 datasets because of lack of plausibility and missing data (initially 3058 eyes with surgery in our centre). Visual acuity (VA), refraction, comorbidities and further data were correlated to patient satisfaction with cataract surgery. The average age of our patients was 74.5 years (Cataracta senilis 96.51%) and they had a mean VA increase from decimal 0.4 ± 0.2 (LogMAR 0.5 ± 0.3) to 0.8 ± 0.3 (LogMAR 0.2 ± 0.2). The target refraction was reached by 78.9% (respectively 49.9%) of the eyes within ± 1.0 D (respectively ± 0.5 D). Factors correlating with a positive overall satisfaction of the patients with surgery were the postoperative increase of VA (Spearman, r = 0.404, p = 0.01), the absence of comorbidities (Spearman, r = - 0.168, p = 0.01) and absence of perioperative complications (Spearman, r = - 0.104, p = 0.01). 1.7% of our patients were dissatisfied despite an increase of VA ≥ 0.1, no comorbidities and no complications. We found the biggest percentage of not satisfied patients without objective reason (Patient-reported Outcome Measure negative/Clinical Outcome Measure positive, PROM-/COM+ 3.9%) in the sector of improvement of reading abilities. With a not preselected patient cohort, we reached internationally comparable visual, refractive and satisfaction results. The overall satisfaction with cataract surgery is high. The majority of our patients (84.2%) were PROM+ combined with COM+ (VA increase ≥ 0.1). Dissatisfaction could be explained by the presence of comorbidities, perioperative complications and with a poor surgical outcome (no increase of VA ≥ 0.1). Nevertheless 1.7% of our patients remained unsatisfied without an objective reason (COM+, PROM-), which underlines the importance of general life satisfaction.

Use of Spectacles after Cataract Surgery

“…It is rather remarkable that even in this group, the median satisfaction score was 4 out of 5 stars despite the fact that the preoperative expectations and the actual postoperative outcome clearly did not match. In general, high scores can be found in different studies concerning patient satisfaction, regardless of the implanted IOLs 4 , 5 , 7 , 8 .…”