PREOPERATIVE FUNCTIONAL EXPECTATIONS AND POSTOPERATIVE OUTCOMES AMONGPATIENTS UNDERGOING FIRST EYE CATARACT-SURGERY

Objective: To describe the relationship between patients' preoperative expectations regarding the outcome of cataract surgery and actual pos toperative experience. Methods: A longitudinal study of 772 patients u ndergoing first eye cataract surgery recruited from 75 ophthalmology p ractices in three metropolitan areas was conducted. Prior to surgery a nd approximately 4 months after surgery, a detailed interview was cond ucted that included general and vision-specific health status measures (including the Visual Function 12-Item Scale [VF-12]), patient-report ed level of trouble and satisfaction with vision, and questions addres sing patients' preoperative expectations regarding the outcomes of sur gery. In addition, detailed clinical data were collected preoperativel y and postoperatively. A total of 552 patients had only single eye cat aract surgery by 4 months postoperatively and are included in this ana lysis. Results: Patients' preoperative expectations regarding the impa ct of cataract surgery were very high and were unrelated to their demo graphic or ocular characteristics. The preoperative VF-12 score, howev er, was positively correlated with expected postoperative VF-12 score (Spearman correlation, .45, P<.001). Only 61% of patients achieved or surpassed their expected level of postoperative functioning. The diffe rence between expected and actual postoperative VF-12 scores was not a ssociated with patients' demographic characteristics or provider-relat ed variables. Older patients (>75 years) and patients with ocular como rbidity had a larger difference between expected and actual postoperat ive functioning than younger patients and those without ocular comorbi dity. Conclusion: Expectations regarding visual functioning after cata ract surgery are very high, and in most cases such expectations are fu lfilled. In selected cases, more comprehensive counseling may reduce t he discrepancy between expectations and actual outcomes of cataract su rgery.