Impact of clinical and patient-reported outcomes on patient satisfaction with cataract extraction

Background: To date, factors that influence satisfaction with cataract surgery have not been broadly explored.

Objective: To identify variables related to patient satisfaction after cataract extraction by phacoemulsification and to determine the relationship between satisfaction and visual acuity (VA) and visual function (VF).

Design: Prospective cohort study.

Setting: Five hospitals belonging to the Basque Health Care Service.

Participants: 4335 consecutive patients undergoing cataract extraction.

Interventions: Clinical data on vision were collected before the intervention and 6 weeks afterwards. Before cataract extraction, patients answered a global question about their expectations for the procedure, answered three questions related to specific activities (reading, going out and recognizing people, and doing housework) and completed the Visual Function-14 (VF-14) and Short-Form-36 (SF-36) instruments. Three months after cataract extraction, they again completed the VF-14 and SF-36 along with questions about global satisfaction with the procedure and satisfaction with the three specific activities.

Main outcome measures: Three months after cataract extraction, they again completed the VF-14 and SF-36 along with questions about global satisfaction with the procedure and satisfaction with the three specific activities.

Results: Pre-intervention VA and VF-14 scores and their post-intervention changes were associated with both global satisfaction and satisfaction with the ability to perform specific activities. Unresolved ocular complications were related to global satisfaction with cataract extraction (OR 95% = 0.39(0.27, 0.55) , P < 0.001). Both the mental and physical component scales of the SF-36 were related to global satisfaction. A group of patients were not satisfied with the intervention in spite of achieving similar vision-related improvements as patients who were quite satisfied with the procedure.

Conclusion: Satisfaction with cataract extraction is related to clinical outcomes and is also associated with patients' expectations of their improvement in visual function.