Attitudes and understanding of premium intraocular lenses in cataract surgery: a public health sector patient survey.
Ashmal Jameel, Lucia Dong, Chun Fung Jeffrey Lam, Hana Mahmood, Khayam Naderi, Sancy Low, Elodie Azan, Seema Verma, Scott Robbie, Mani Bhogal, David O'Brart
Author Information
Ashmal Jameel: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Lucia Dong: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Chun Fung Jeffrey Lam: GKT Medical School, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK.
Hana Mahmood: Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK. ORCID
Khayam Naderi: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Sancy Low: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Elodie Azan: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Seema Verma: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
Scott Robbie: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. ORCID
Mani Bhogal: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
David O'Brart: Ophthalmology Dept, Guy's & St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK. david.obrart@gstt.nhs.uk.
OBJECTIVES: To investigate patient understanding of, and attitudes to, premium (toric, extended depth of focus/multifocal) intraocular lenses (premIOLs) in public health sector patients undergoing cataract surgery (CS) in the UK. METHODS: A 12 question survey with Likert scale questions was designed, to assess patient attitudes to post-operative spectacle dependence, refractive target and desirability of spectacle independence whilst considering possible complications of dysphotopsias and need for premIOL exchange/adjustment. RESULTS: 360 surveys were collected. CS had not been performed in 66.5%. Separate spectacles were worn for reading and distance in 28.8%, 19.2% had varifocals, 11.2% bifocals, 22.9% reading glasses only and 1.6% computer glasses only. Contact lenses were not worn in 95.7%. Only 41.6% were drivers. Most patients (85.8%) did not mind wearing glasses after CS, with 78.9% preferring reading glasses, compared with 29.7% preferring distance glasses. Most patients (75.3%) were not familiar with premIOLs, with 58.9% not willing to consider them in the context of a 2% risk of debilitating dysphotopsia and 54.2% rejecting a 5% risk of second surgery. CONCLUSIONS: There is a lack of awareness of premIOLs in public health sector (NHS) patients in the UK, suggesting limitations in the "fully informed" consent process for CS. Most NHS CS patients are currently willing to wear spectacles after CS, especially reading glasses. There is reluctance in such patients to consider premIOLs on a background of small risks of debilitating dysphotopsias and increased risks of a second operation.
References
Am J Ophthalmol. 2017 Aug;180:165-177
[PMID: 28647461]
