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Psychometric factors in patient decision-making process for laser refractive surgery

Poster Details

First Author: C.Lam HONG KONG

Co Author(s):    T. Mok   K. Shih                 

Abstract Details


popular laser refractive surgeries and studies have suggested that that both techniques result in comparable clinical outcomes. Examination of associations between personality traits and interest in undergoing refractive surgery would improve the consultation experience for patients and to facilitate them in making the best decision for their eyes. The objective of this study was to investigate the role of personality traits in choosing refractive surgery using the Big Five Inventory (BFI) for assessing the five personality dimensions to determining the kind of personality people wanting perfect vision might have.


100 consecutive subjects interested in laser refractive surgery (LASIK or SMILE) at the Guy Hugh Chan Laser Refractive Surgery Centre at the Hong Kong Sanatorium and Hospital and 75 age and education level-matched subjects not interested in refractive surgery were recruited between November 2018 to October 2019.


All 175 participates were asked to complete a questionnaire including the 44-item BFI and some demographic details. 168 questionnaires without missing were analysed (100 patients, 68 controls). A single surgeon (Dr. Tommy Chan) at the Hong Kong Sanatorium and Hospital was responsible for explaining both procedures in detail to the patients before making the final decision of which refractive surgery they would choose. Two-tailed T test and Chi squared test were performed to determine the associations between the group undergoing surgery and the controlled group, as well as the group undergoing LASIK and the group undergoing SMILE.


A mild difference in personalities was found between participants interested in refractive surgery (LASIK/SMILE) and participants not interested refractive surgery. In aspects of extraversion, agreeableness, conscientiousness and openness, two groups performed similarly (p = 0.15, p = 0.25, p = 0.75 and p= 0.52 respectively) except for neuroticism, which was found to be statistically significant with a p value <0.05. Comparing between LASIK and SMILE group, the result was even more significant with the SMILE group. Chi-squared test revealed that both groups of participants were education level-matched given the statistically insignificant p-value. However, p = 0.0008 (<0.05) was found for occupation, with the group undergoing refractive surgery more likely to be involved in service or retail compared to the control group.


SMILE has emerged to be a popular technique for myopia correction, providing comparable, if not better, refractive outcome to LASIK. We observed that people who are more neurotic are more likely to undergo refractive surgery, and interestingly, people choosing SMILE are even more neurotic than those choosing LASIK. This can be explained by the fact that perfect vision is more important to neurotic patients. In view of this, doctors can be more mindful of this when discussing and preparing the expectations of patients undergoing refractive surgery.

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