School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK.
Leeds Sustainability Institute, Leeds Beckett University, Leeds, UK.
Ophthalmic Physiol Opt. 2020 Sep;40(5):540-548. doi: 10.1111/opo.12709. Epub 2020 Jul 11.
Most patients report being highly satisfied with the outcome of cataract surgery but there are variable reports regarding the impact of cataract surgery on some real-world activities, such as fall rates. We hypothesised that adaptations to changed refractive correction and visual function may cause difficulties in undertaking everyday activities for some patients and used a series of focus groups to explore this issue.
Qualitative methods were used to explore patients' experiences of their vision following cataract surgery, including adaptation to vision changes and their post-surgical spectacle prescription. Twenty-six participants took part in five focus groups (Mean age = 68.2 ± 11.4 years), and the data were analysed using thematic analysis.
We identified three themes. 'Changes to Vision' explores participants' adaptation following cataract surgery. While several had problems with tasks relying on binocular vision, few found them bothersome and they resolved following second eye surgery. Participants described a trial and error approach to solving these problems rather than applying solutions suggested by their eyecare professionals. 'Prescription Restrictions' describes the long-term vision problems that pre-surgery myopic patients experienced as a consequence of becoming emmetropic following surgery and thus needing spectacles for reading and other close work activities, which they did not need before surgery. Very few reported that they had the information or time to make a decision regarding their post-operative correction. 'Information Needs' describes participant's responses to the post-surgical information they were given, and the unmet information need regarding when they can drive following surgery.
The findings highlight the need for clinicians to provide information on adaptation effects, assist patients to select the refractive outcome that best suits their lifestyle, and provide clear advice about when patients can start driving again. Patients need to be provided with better guidance from clinicians and prescribing guidelines for clinicians would be beneficial, particularly for the period between first- and second-eye surgery.
大多数患者对白内障手术后的结果非常满意，但对于白内障手术对某些真实世界活动（如跌倒率）的影响，报告结果存在差异。我们假设，由于改变了屈光矫正和视觉功能，一些患者在进行日常活动时可能会遇到困难，并使用一系列焦点小组来探讨这个问题。
采用定性方法探讨患者白内障手术后的视力体验，包括对视力变化的适应和术后眼镜处方。26 名参与者参加了 5 个焦点小组（平均年龄=68.2±11.4 岁），数据采用主题分析进行分析。
我们确定了三个主题。“视力变化”探讨了参与者白内障手术后的适应情况。虽然一些人在依赖双眼视觉的任务中存在问题，但很少有人觉得这些问题很麻烦，在第二只眼手术后这些问题就解决了。参与者描述了一种尝试和错误的方法来解决这些问题，而不是采用他们的眼保健专业人员建议的解决方案。“处方限制”描述了术前近视患者在手术后成为正视眼后长期存在的视力问题，因此需要戴眼镜进行阅读和其他近距离工作活动，而在手术前他们不需要戴眼镜。很少有人报告说他们有信息或时间来决定术后矫正。“信息需求”描述了参与者对术后信息的反应，以及他们在手术后何时可以再次开车的信息需求未得到满足。
研究结果强调了临床医生提供适应效果信息的必要性，帮助患者选择最适合其生活方式的屈光结果，并就术后何时可以再次开车提供明确的建议。需要向患者提供来自临床医生的更好指导，为临床医生制定处方指南将是有益的，特别是在第一只眼和第二只眼手术之间的时期。
