PATIENT SATISFACTION AND ATTITUDES TOWARDS IMMEDIATE SEQUENTIAL BILATERAL CATARACT SURGERY: A QUALITATIVE STUDY USING THEMATIC ANALYSIS

To investigate the experiences of patients undergoing immediate sequential bilateral cataract surgery (ISBCS) in the public sector.

Royal Bournemouth Hospital Eye Unit, University Hospitals Dorset (UK National Health Service)

Consecutive patients undergoing ISBCS supervised by a single surgeon over a one-year period were identified. Cases were excluded if they involved general anaesthesia, were performed within the private sector, or were unable to be contacted. All eyes met the local NHS criteria for cataract surgery based on visual acuity and / or vision-related quality of life. At least four weeks postoperatively, semi-structured interviews were conducted by an independent interviewer to explore the patient’s experiences peri- and post-operatively. Qualitative analysis of the responses was performed, alongside an assessment of postoperative function using a Modified Barthel Activity of Daily Living Score.

25 patients were included. Most had both eyes treated by the same surgeon, with 16% having a different surgeon for their second eye. The most frequent reason for choosing ISBCS was the convenience of a single visit to hospital (88%), with 20% specifically citing coronavirus as a reason for wanting to limit exposure to a healthcare environment. All patients were happy to proceed with their second eye after surgery on the first eye was complete. All patients were satisfied postoperatively, with 96% saying they would recommend ISBCS to friends and family. Minimal reductions in function were reported in the early postoperative period. Preoperative concerns regarding the idea of ISBCS that require additional counselling included: fear of no vision bilaterally due to padding after surgery; fear of bilateral complications; lack of familiarity with ISBCS among friends and family. Differences in the second eye experience were raised as a concern when a different surgeon treated each eye.

In appropriately selected and counselled patients, ISBCS results in high levels of patient satisfaction. Written information regarding the common themes of concern identified in this study can assist preoperative counselling and potentially increase uptake. When different surgeons are treating each eye, both should be of similar ability and adopt a standardised surgical approach.