Visual and non-visual factors associated with patient satisfaction and quality of life in LASIK

Jara, Percy Lazon de la; Erickson, Dale; Erickson, Paul; Stapleton, Fiona

doi:10.1038/eye.2011.151

Cited by 34 publications

(41 citation statements)

References 31 publications

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“…8,46,47 In the PROWL studies, satisfaction with vision increased from baseline, but 1% (95% CI, 0%-4%) to 4% (95% CI, 2%-7%) of participants had some level of dissatisfaction with vision 3 to 6 months after surgery. The total number of dissatisfied participants in the PROWL studies was too small to assess associations with other factors.…”

Section: Discussionmentioning

confidence: 99%

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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IMPORTANCE Patient-reported outcomes should be collected using validated questionnaires prior to and following laser in situ keratomileusis (LASIK) surgery.OBJECTIVE To report the frequency of patient-reported visual symptoms, dry eye symptoms, satisfaction with vision, and satisfaction with LASIK surgery in the Patient-Reported Outcomes With LASIK (PROWL) studies. DESIGN, SETTING, AND PARTICIPANTSThe PROWL-1 and PROWL-2 studies were prospective, observational studies conducted from September 13, 2011, to June 27, 2014. The PROWL-1 study was a single-military center study of 262 active-duty Navy personnel 21 to 52 years of age. The PROWL-2 study was a study of 312 civilians 21 to 57 years of age conducted at 5 private practice and academic centers. The LASIK surgery and the postoperative care were performed based on the usual practice and clinical judgment at the site. Participants completed a self-administered, web-based questionnaire, preoperatively and postoperatively at 1 and 3 months (the PROWL-1 and -2 studies) and at 6 months (the PROWL-2 study).EXPOSURES Participants underwent LASIK surgery for myopia, hyperopia, and/or astigmatism. MAIN OUTCOMES AND MEASURESVisual symptoms (double images, glare, halos, and/or starbursts), dry eye symptoms, participant satisfaction (with vision and LASIK surgery), and clinical measures (visual acuity, refractive error, and slitlamp and posterior segment eye examination findings) were assessed preoperatively and at 1, 3, and 6 months postoperatively.RESULTS A total of 262 participants were enrolled in the PROWL-1 study (mean [SD] age, 29.1 [6.1] years), and a total of 312 participants were enrolled in the PROWL-2 study (mean [SD] age, 31.5 [7.3] years). Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months). The percentages of participants in the PROWL-1 study with normal Ocular Surface Disease Index scores were 55% (95% CI, 48%-61%) at baseline, 66% (95% CI, 59%-72%) at 3 months, and 73% (95% CI, 67%-79%) at 6 months. The percentages of participants in the PROWL-2 study with normal Ocular Surface Disease Index scores were 44% (95% CI, 38%-50%) at baseline and 65% (95% CI, 59%-71%) at 3 months. Of those participants who had normal scores at baseline in both the PROWL-1 and -2 studies, about 28% (95% CI, 19%-37%) had mild, moderate, or severe dry eye symptoms at 3 months. While most participants were satisfied, the rates of dissatisfaction with vision ranged from 1% (95% CI, 0%-4%) to 4% (95% CI, 2%-7%), and the rates of dissatisfaction with surgery ranged from 1% (95% CI, 0%-4%) to 2% (95% CI, 1%-5%). CONCLUSIONS AND RELEVANCEThe systematic administration of a questionnaire to patients who have undergone LASIK surgery is a new approach to assess symptoms and satisfaction. Our findi...

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Section: Discussionmentioning

confidence: 99%

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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“…Improved satisfaction and function lead to a significant change in psychological characteristics of the patients, including a more positive attitude toward life following keratorefractive surgery, which was thought to be due to a decrease in the frequency of disturbing visual and ocular symptoms. 6 Tahzib et al 56 Similarly, patient satisfaction after PRK is excellent. Guerin et al 57 2-year follow-up of 120 patients who underwent myopic PRK found that 100% of patients would want to have the surgery again.…”

Section: ' Overall Patient Satisfactionmentioning

confidence: 95%

“…In general, while quality of life has been shown to improve significantly following refractive surgical procedures, 6 we plainly tell patients that we expect their postoperative uncorrected distance visual acuity (UCDVA) to be equal to preoperative best-corrected distance visual acuity (BCDVA). Many studies have shown that some percentage of patients will gain lines in best-corrected visual acuity following refractive surgery, but this is not true of a majority of patients.…”

Section: ' Preoperative Patient Counselingmentioning

confidence: 98%

Managing Expectations in Refractive Surgery

Alexander¹,

Davidson²

2016

International Ophthalmology Clinics

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Success in refractive surgery requires equal parts clinical insight and setting and managing appropriate patient expectations. Preoperative expectations predict satisfaction following refractive surgical procedures, and managing these expectations is essential to achieving a successful refractive surgical experience for both the surgeon and the patient. In this review, we describe our approach to managing expectations for laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and phakic intraocular lenses (PIOLs). We provide an overview of patient selection, preoperative patient counseling, postoperative visual acuity and refractive results, and refractive stability. We discuss the large published reviews comparing outcomes of surgical procedures pitted against one another as well as postoperative issues, including night vision complaints, contrast sensitivity, and surgical complications. Finally, we comment on overall patient satisfaction following these life-altering surgical procedures. ' Patient and Procedure SelectionThe clear goal of any refractive surgical procedure is spectacle independence, and the first step in reaching this goal is to determine which techniques are appropriate to treat the individual patient. The decision must be based on the patient's refractive error and the findings of a full ophthalmic history and examination. Then, based on patient age, profession, and hobbies (visual needs), the surgeon and patient should collaboratively and objectively set visual goals for refractive surgery.

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“…Patient satisfaction following LASIK is related to post‐operative visual function; however, pre‐operative expectations and psychological characteristics are heavily related to the perceived success of the procedure . The potential patient must be thoroughly counselled to assess visual requirements and post‐operative expectations.…”

Section: Patient Selectionmentioning

confidence: 99%