Only eye study 2 (OnES 2): ‘Am I going to be able to see when the patch comes off?’ A qualitative study of patient experiences of undergoing high-stakes only eye surgery

Jones, Lee; Taylor, D. Wayne; Sii, Freda; Masood, Imran; Crabb, David P.; Shah, Peter

doi:10.1136/bmjopen-2020-038916

Cited by 14 publications

(23 citation statements)

References 46 publications

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“…The perceived stability of the optometric workforce is expected to result in a stable optometrist-delivered SLT service, independent of the availability and rotations of ophthalmologists. Continuity of care could be improved, reducing medical costs, service use and complications [ 15 , 16 ], whilst being welcomed by patients [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Selective laser trabeculoplasty (SLT) performed by optometrists—enablers and barriers to a shift in service delivery

Konstantakopoulou

Jones

Nathwani

et al. 2021

Eye

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Background/objectives To explore the acceptability, training requirements, enablers and barriers of optometrist-delivered SLT. Subjects/methods Optometrists, fellowship and consultant grade ophthalmologists, hospital managers and patients were interviewed using pre-defined topic guides. Interviews were audio-recorded, transcribed, and subjected to thematic analysis. Overarching themes were defined by the study aims and the topic guides; subthemes were derived from the interview data. Results Sixty-six participants (three managers, eight glaucoma specialist consultant ophthalmologists, seven clinical glaucoma fellows, 12 optometrists (two of them performing SLT), two ophthalmic nurses and 34 patients) participated in the study. Overarching themes (and subthemes) were: necessity of non-medical SLT delivery, clinical practice and training, advantages, disadvantages, concerns, challenges, community delivery of SLT, patient values and other healthcare professionals that could also deliver SLT. Conclusions Certain clinical pre-requisites, such as gonioscopy and independent prescribing rights, were perceived as necessary for undertaking SLT training. An optometrist-delivered SLT service was expected to benefit the NHS, but there was an identified need of a standardised training scheme and robust governance. Patients were accepting of an optometrist-delivered SLT service in the hospital eye service.

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Section: Discussionmentioning

confidence: 99%

Selective laser trabeculoplasty (SLT) performed by optometrists—enablers and barriers to a shift in service delivery

Konstantakopoulou

Jones

Nathwani

et al. 2021

Eye

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“…Moreover, by recruiting from two locations serving urban, suburban and rural populations, we aimed to include the full spectrum of social diversity across the UK. In common with previous qualitative studies, this permits a degree of conceptual transference in UK glaucoma patients under NHS care [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 94%

Treatment expectations in glaucoma: what matters most to patients?

Safitri

Konstantakopoulou

et al. 2023

Eye

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Background/Objectives Recent clinical trials in glaucoma have used patient-reported outcome measures (PROMs) of health-related quality of life to evaluate interventions. However, existing PROMs may not be sufficiently sensitive to capture changes in health status. This study aims to determine what really matters to patients by directly exploring their treatment expectations and preferences. Subjects/Methods We conducted a qualitative study using one-to-one semi-structured interviews to elicit patients’ preferences. Participants were recruited from two NHS clinics serving urban, suburban and rural populations in the UK. To be relevant across glaucoma patients under NHS care, participants were sampled to include a full range of demographic profiles, disease severities and treatment histories. Interview transcripts were evaluated using thematic analysis until no new themes emerged (saturation). Saturation was established when 25 participants with ocular hypertension, mild, moderate and advanced glaucoma had been interviewed. Results Themes identified were: Patients’ experiences of living with glaucoma, patients’ experiences of having glaucoma treatment, most important outcomes to patients, and COVID-related concerns. Participants specifically expressed their most important concerns, which were (i) disease-related outcomes (intraocular pressure control, maintaining vision, and being independent); and (ii) treatment-related outcomes (treatment that does not change, drop-freedom, and one-time treatment). Both disease-related and treatment-related experiences were covered prominently in interviews with patients across the spectrum of glaucoma severity. Conclusions Outcomes related both to the disease and its treatment are important to patients with different severities of glaucoma. To accurately evaluate quality of life in glaucoma, PROMs may need to assess both disease-related and treatment-related outcomes.

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“…The psychological state of the patient was considered in the Only Eye Study 2 (OnES 2). 16 Patient anxiety was found to be prevalent amongst those undergoing only eye surgery. This should also be taken into consideration as patient cooperation is an important part of ensuring safe cataract surgery under local anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes in only eye cataract surgery

Doyle

Haq

Aslam

2022

European Journal of Ophthalmology

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Introduction Performing cataract surgery in the setting of only one seeing-eye has significant benefits but also potential negative consequences for both patient and surgeon. This study investigates the surgical outcomes in patients undergoing cataract surgery on their only seeing-eye. Methods A retrospective analysis was conducted in a single tertiary centre of all adult patients who had undergone cataract surgery on their only eye, where the fellow eye had a vision of 1.0 LogMAR or worse. Complication rates and visual outcomes were compared against data from the National Ophthalmology Database (NOD) Audit. Results 918 patients underwent cataract surgery on their only seeing-eye and had their postoperative visual acuity recorded. The overall unadjusted complication rate was 4.0% (versus 2.5% from NOD data) with the rate of posterior capsule rupture (PCR) being 1.9% (versus 1.14% from NOD data). 72.5% (versus 91.5% from NOD data) of patients attained a post-operative visual acuity of 0.3 LogMAR or better. The grade of surgeon performing the surgery did not have a statistically significant effect on the risk of complications. Discussion In this cohort of only-eye patients undergoing cataract surgery, there was a small increased risk of operative complications including an increased, unadjusted risk of PCR, and fewer eyes achieved 0.3 LogMAR vision post-operatively compared to the NOD audit data. Grade of surgeon did not have an impact on the complication rate, indicating that with appropriate supervision, trainee surgeons may gain experience in only-eye surgery without additional risk to the patient. Further multicentre studies are recommended to assess reproducibility across units.

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Only eye study 2 (OnES 2): ‘Am I going to be able to see when the patch comes off?’ A qualitative study of patient experiences of undergoing high-stakes only eye surgery

Cited by 14 publications

References 46 publications

Selective laser trabeculoplasty (SLT) performed by optometrists—enablers and barriers to a shift in service delivery

Selective laser trabeculoplasty (SLT) performed by optometrists—enablers and barriers to a shift in service delivery

Treatment expectations in glaucoma: what matters most to patients?

Surgical outcomes in only eye cataract surgery

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