Investigation into enhanced patient consultation on post-cataract surgery patient satisfaction with visual outcomes

Project Details


Cataract surgery offers an opportunity to correct pre-existing refractive error and surgeons can accurately plan post-operative ocular refractive power1. Current NHS guidelines aims within 0.50-1.00D of emmetropia2 (achieved for 95%3) looking for clear unaided distance vision. Despite the manipulation of refractive correction involved, unlike other refractive procedures, little attention is given to the impact of a large and sudden change to the overall refractive status and little evidence surgeons are encouraged to aim for anything other than emmetropia4. Anecdotal evidence from practitioners suggest some (myopic) patients, would prefer under correction to maintain clear unaided near vision they are accustomed to. However, this is not routine despite guidance to this effect in both Ophthalmologist and Optometrists standards5,64. Recent increase in the assessment of patient satisfaction with their post-operative outcome7-13can be utilised to inform this trend

Executed in two phases (first informs the second), this project aims to establish an evidence base to inform best practice regarding patient consultation around correction prior to cataract surgery. (1) An assessment of patient satisfaction with post-operative visual correction with current guidance; (2) An intervention using an enhanced patient consultation to tailor the target post-operative refractive error to the patient’s needs. This PhD project will provide essential pilot data as required to plan a future cluster design RCT. The student will establish the feasibility of delivering and assessing this intervention and directly assess the impact of patient consultation on post-operative refractive error on newly pseudophakic patients’ visual comfort and satisfaction.

1. To determine the myopic patient satisfaction with visual outcome after standard cataract surgery.
2. To assess the feasibility of delivering an enhanced patient consultation and intervention within an NHS setting

Ophthalmology Department, Hairmyres NHS University Hospital, Lanarkshire*

*The supervision team is working closely with consultant ophthalmologist Mr Douglas Lyall (NHS Lanarkshire), who will be acting as the key surgeon for the project. We also have support from NHS Lanarkshire R&D department

1Apple D. Evolution of Cataract Surgery and Intraocular Lenses (IOLs). Surv Ophthalmol 2000; 45: S53-S69
2Gale RP, Saldana M, Johnston RL, Zuberbuhler B, McKibbin M. Benchmark standards for refractive outcomes after NHS cataract surgery. Eye 2007; 23: 149-152
3Brogan K, Diaper CJM, Rotchford AP. Cataract surgery refractive outcomes: representative standards in a National Health Service setting. Br J Ophthalmol 2018
4Khadka J, Huang J, Chen H, Chen C, Gao R, Bao F, Zhang S, Wang Q, Pesudovs K. Assessment of Cataract Surgery Outcome Using the Modified Catquest Short-Form Instrument in China. PLoS One 2016; 11: e0164182
5RCO. Quality Standard: Correct IOL implantation in cataract surgery. In: Ophthalmologists RCo, ed, 2018; 4
6GOC. Standards of Practice. In: Council GO, ed London, UK, 2016; 6
7Mollazadegan K, Lundstrom M. A study of the correlation between patient-reported outcomes and clinical outcomes after cataract surgery in ophthalmic clinics. Acta Ophthalmol 2015; 93: 293-298
8Wang SY, Stem MS, Oren G, Shtein R, Lichter PR. Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review. Eur J Ophthalmol 2017: 0
9Bilbao-Calabuig R, Llovet-Rausell A, Ortega-Usobiaga J, Martinez-Del-Pozo M, Mayordomo-Cerda F, Segura-Albentosa C, Baviera J, Llovet-Osuna F. Visual Outcomes Following Bilateral lmplantation of Two Diffractive Trifocal IOLs in 10,084 eyes. Am J Ophthalmol 2017
10Goldberg DG, Goldberg MH, Shah R, Meagher JN, Ailani H. Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost. BMC Ophthalmol 2018; 18: 293
11Buscacio ES, Patrao LF, de Moraes HV, Jr. Refractive and Quality of Vision Outcomes with Toric IOL Implantation in Low Astigmatism. Journal of ophthalmology 2016; 2016: 5424713
12Fung SS, Luis J, Hussain B, Bunce C, Hingorani M, Hancox J. Patient-reported outcome measuring tools in cataract surgery: Clinical comparison at a tertiary hospital. J Cataract Refract Surg 2016; 42: 1759-1767
13Kandel H, Khadka J, Lundstrom M, Goggin M, Pesudovs K. Questionnaires for Measuring Refractive Surgery Outcomes. J Refract Surg 2017; 33: 416-+

This is a partially funding PhD studentship project. GCU and The Vision Research Trust have agreed to fund the project jointly. The PhD student began their studies 1st October 2021
StatusNot started

UN Sustainable Development Goals

In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. This project contributes towards the following SDG(s):

  • SDG 3 - Good Health and Well-being


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