Transforming The ‘Paper’ Cataract Information Leaflet Into A Digital/Video/Interactive Format To Improve Patient Education/Retention

Cataract surgery is one of the most commonly performed surgical procedures within the NHS, with over 450,000 performed in England itself in 2019/2020. The cataract surgery consent process currently involves discussing the risks and benefits with the patient, and providing the patient with an A4 leaflet detailing important information regarding the operation and further information. However, patients requiring cataract surgery have problems with their eyesight (due to the cataract). This can impede their ability to read the information leaflet. Additionally, we are not convinced regarding the retention rate when patients read these leaflets – in particular how much of it is understandable and remembered by the patient.

To determine the most important aspects of cataract surgery consent are from a patient-centred as well as from a surgical perspective to aid in the transformation of the existing Moorfields Eye Hospital cataract information leaflet into a video format. A qualitative questionnaire was distributed to patients undergoing their first or second cataract operation. A five-point Likert scale was used with 1 being least important and 5 being most important.

The importance of the following was measured: definition of a cataract, cause of cataracts, other treatments other than surgery, outcome without surgery, chance of improvement in vision following surgery, when vision will improve, general nature of cataract surgery, technical details of the operation, who the surgeon will be, anaesthetic details, overall risk of vision loss from surgery, types of serious complications, all complications whether serious or minor. A blank space questionnaire was sent to all consultant ophthalmologists performing predominantly cataract surgery at Moorfields Eye Hospital for their top 3 most important pieces of information to get across to patients undergoing cataract surgery. 

The questionnaire was completed by 38 patients (17 male, 21 female, 19 first eye, 19 second eye) with a mean age of 71.7 (SD 15.3). The five most important aspects rated by importance by the patients were chance of improvement in vision (mean 4.78, SD 0.46), when vision will improve (mean 4.69, SD 0.66), overall risk of vision loss (mean 4.53, SD 0.95), types of serious complications (mean 4.43, SD 1.05), general complications (mean 4.43, SD 1.01). This is reflected by the consultant-body responses with the top three most important single pieces of information rated as need for glasses post-operatively (21.2%), general risks involved in cataract surgery (18.2%), and 1/1000 chance of severe vision loss/blindness (12.1%). 

The aspects of cataract consent determined to be most important to patients closely reflect those of the surgical team/medicolegal perspective. The results will be utilised to produce an animated video of 2-3 minutes duration explaining the most important aspects of cataract surgery from both a clinical and patient perspective as an adjunct to the current listing/consenting of patients to improve understanding, retention of information, and to improve access. The video design will cover the most important aspects which offers the most benefit to the patient whilst simultaneously covering the key medicolegal elements.