Improving cataract surgery outcomes starts with pre-op patient education
Cataract surgery is one of the most commonly performed procedures in the world, and one with the highest patient satisfaction rates. It is more effective than ever, thanks to advances in surgical techniques and intraocular lenses (IOLs). However, patients can be surprised or disappointed with their outcomes if they don’t fully understand their options or have unrealistic expectations.
Eye care providers know it’s important to educate patients and help them understand their choices and vision goals well before cataract surgery is scheduled. Here are the top patient complaints, and how to address them before and after surgery.
Complaint #1: “I still have to wear glasses after cataract surgery.”
Patients are often surprised when they still need to wear glasses or contacts following their procedure. This indicates a lack of patient education upfront. “The best way to deal with post-op issues is to not have to deal with them because you’ve taken the time to understand what patients want before surgery,” said ophthalmologist Mark Kontos, MD, in the Review of Optometry. “Understanding their expectations can significantly increase the likelihood of achieving happiness.”
Ask pre-op patients about their jobs, hobbies and lifestyles to understand their visual priorities.
He asks some key questions to pre-op patients, including, “Do you want to be free of glasses entirely?” and “Do you want to read without glasses but don’t care about wearing glasses to see clearly at a distance?” Asking about patients’ jobs, hobbies and lifestyles is important, too, to help understand patients’ visual priorities. Patients need specific counseling to understand residual astigmatism will be an issue if they don’t address their astigmatism at the time of surgery.
Showing patients this video can help guide their choices:
Complaint #2: “Ever since the surgery I see glare and halos when I drive at night.”
Discussing vision goals and expectations for post-op results is more effective when you can show patients, rather than just telling them. Patients who have a better understanding of common side effects, especially when they can differ based on IOL choice, can make more informed decisions about which lens choice is right for them.
Callout: Use Outcome Simulator to compare treatment options side by side and show patients how a certain lens may affect glare or blur.
Rendia’s Outcome Simulator was designed specifically for this purpose. Choose from several realistic scenes, such as nighttime driving or reading fine print, then simulate patients’ current, uncorrected vision next to a treatment option to show how vision may change with the selected treatment. You can show patients the “before” and “after” next to each other and even compare treatment options side by side to show differences at a glance. This illustrates clearly to patients how a particular lens may affect glare or blur, for instance.
Let patients know that most people eventually adapt to side effects like glare and halos. Some doctors even find it helpful to show patients Outcome Simulator again after surgery to demonstrate the improvement, since many patients forget how poor their vision was pre-operatively.
Complaint #3: “My eyes feel irritated and my vision fluctuates.”
Managing ocular surface disease plays a role before and after surgery, noted the authors of the article, “Troubleshooting Unhappy Cataract Surgery Patients,” in Modern Optometry. While doctors know that OSD, including dry eye disease, can have an impact on surgical outcomes, patients may not realize this. In fact, they may not be aware that they even have dry eye.
Untreated ocular surface disease can be the cause of cataract patient dissatisfaction and/or refractive error.
The authors recommend to “treat and optimize the ocular surface, as this could be the cause of their dissatisfaction and/or refractive error” before discussing how to approach correcting a patient’s postoperative refractive error. Even if a patient doesn’t present with classic complaints of OSD, they recommend pursuing a dry eye workup.