K Pesudovs, DJ Coster
Department of Ophthalmology, Flinders Medical Centre and Flinders University of South Australia

Purpose. To determine the factors influencing patient satisfaction after cataract surgery. The factors considered were pre-operative cataract, visual disability (Vdis), objective tests of visual function, patient expectations and post-operative Vdis and objective tests of visual function.

Methods. Cataract surgery was performed on 121 patients (56 without ocular comorbidity and 65 with ocular comorbidity). Pre-operatively, cataract was quantified using the Lens Opacities Classification System III. Visual disability was assessed with the Visual Disability Assessment, a previously validated questionnaire. Expectations were also assessed by questionnaire. A battery of tests of visual function were applied pre- and post-operatively. Satisfaction was also assessed by questionnaire. The relationships between variables were explored using partial least squares path analysis in 2 models, one for patients without ocular comorbidity and one for the entire cohort.

Results. Cataract only patients with less post-operative VDis b = -0.67, less post-operative ametropia b = -0.22 or lower patient expectations b = -0.19 were more satisfied. Comorbidity patients with more pre-operative VDis b = 0.34 or better post-operative vision b = -0.31 were more satisfied. Post-operative ametropia was not as significant in the comorbidity group b = -0.17.

Conclusions. Minimisation of post-operative visual disability is the most important determinant of patient satisfaction after cataract surgery. Patients with lower expectations of the outcome of cataract surgery are more likely to be satisfied. Patients without ocular comorbidity are keen for good unaided vision after cataract surgery. Patients with ocular comorbidity consider the refractive outcome to be of less importance; they are more likely to be satisfied with the outcome of cataract surgery if they had more pre-operative visual disability or better post-operative vision.