Referrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: Reasons for patient dissatisfaction

Levinson, Brett A.; Rapuano, Christopher J.; Cohen, Elisabeth J.; Hammersmith, K.M.; Ayres, Brandon D.; Laibson, Peter R.

doi:10.1016/j.jcrs.2007.08.028

Cited by 75 publications

(50 citation statements)

References 15 publications

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“…The total number of dissatisfied participants in the PROWL studies was too small to assess associations with other factors. Similar to other studies, 9,11,12,21,42,48 we found that lower satisfaction with vision and surgery was often associated with worse dry eye and visual symptom scores and the use of corrective lenses. To better understand which patients are more likely to be dissatisfied postoperatively, a large observational study, including participants with long-term follow-up after LASIK surgery, would be necessary to accurately estimate the prevalence and find useful predictors for these perceptions.…”

Section: Discussionsupporting

confidence: 90%

“…However, exploratory analyses suggested that dry eye symptoms were associated with visual Dry eye is one of the most common complications reported after LASIK surgery. 7,9,11,[35][36][37][38] Using the OSDI, with its limitations, 39 our findings for dry eye symptoms were incon- All correlations were performed using Spearman rank-order correlation coefficients (satisfaction score vs OSDI Score; all P < .001). Each panel shows analyses with satisfaction scores for 1 of 2 types of satisfaction: satisfaction with vision (A) and satisfaction with surgery (B).…”

Section: Discussionmentioning

confidence: 99%

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Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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IMPORTANCE Patient-reported outcomes should be collected using validated questionnaires prior to and following laser in situ keratomileusis (LASIK) surgery.OBJECTIVE To report the frequency of patient-reported visual symptoms, dry eye symptoms, satisfaction with vision, and satisfaction with LASIK surgery in the Patient-Reported Outcomes With LASIK (PROWL) studies. DESIGN, SETTING, AND PARTICIPANTSThe PROWL-1 and PROWL-2 studies were prospective, observational studies conducted from September 13, 2011, to June 27, 2014. The PROWL-1 study was a single-military center study of 262 active-duty Navy personnel 21 to 52 years of age. The PROWL-2 study was a study of 312 civilians 21 to 57 years of age conducted at 5 private practice and academic centers. The LASIK surgery and the postoperative care were performed based on the usual practice and clinical judgment at the site. Participants completed a self-administered, web-based questionnaire, preoperatively and postoperatively at 1 and 3 months (the PROWL-1 and -2 studies) and at 6 months (the PROWL-2 study).EXPOSURES Participants underwent LASIK surgery for myopia, hyperopia, and/or astigmatism. MAIN OUTCOMES AND MEASURESVisual symptoms (double images, glare, halos, and/or starbursts), dry eye symptoms, participant satisfaction (with vision and LASIK surgery), and clinical measures (visual acuity, refractive error, and slitlamp and posterior segment eye examination findings) were assessed preoperatively and at 1, 3, and 6 months postoperatively.RESULTS A total of 262 participants were enrolled in the PROWL-1 study (mean [SD] age, 29.1 [6.1] years), and a total of 312 participants were enrolled in the PROWL-2 study (mean [SD] age, 31.5 [7.3] years). Visual symptoms and dissatisfaction with vision were common preoperatively. Overall, the prevalence of visual symptoms and dry eye symptoms decreased, although a substantial percentage of participants reported new visual symptoms after surgery (43% [95% CI, 31%-55%] from the PROWL-1 study and 46% [95% CI, 33%-58%] from the PROWL-2 study at 3 months). The percentages of participants in the PROWL-1 study with normal Ocular Surface Disease Index scores were 55% (95% CI, 48%-61%) at baseline, 66% (95% CI, 59%-72%) at 3 months, and 73% (95% CI, 67%-79%) at 6 months. The percentages of participants in the PROWL-2 study with normal Ocular Surface Disease Index scores were 44% (95% CI, 38%-50%) at baseline and 65% (95% CI, 59%-71%) at 3 months. Of those participants who had normal scores at baseline in both the PROWL-1 and -2 studies, about 28% (95% CI, 19%-37%) had mild, moderate, or severe dry eye symptoms at 3 months. While most participants were satisfied, the rates of dissatisfaction with vision ranged from 1% (95% CI, 0%-4%) to 4% (95% CI, 2%-7%), and the rates of dissatisfaction with surgery ranged from 1% (95% CI, 0%-4%) to 2% (95% CI, 1%-5%). CONCLUSIONS AND RELEVANCEThe systematic administration of a questionnaire to patients who have undergone LASIK surgery is a new approach to assess symptoms and satisfaction. Our findi...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

et al. 2017

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“…[22][23][24] The regression analysis between selected subsets in the IER QOL scale and objective clinical data showed a significant association between the change in satisfaction post-LASIK and preoperative satisfaction, postoperative frequency of disturbing visual and ocular symptoms, postoperative MSE, and postoperative scotopic HCVA. Patients dissatisfied with their preoperative optical correction showed higher levels of change in satisfaction if a reduction in the frequency of disturbing symptoms, low levels of post MSE, and good levels of scotopic VA were achieved after LASIK.…”

Section: Discussionmentioning

confidence: 96%

Visual and non-visual factors associated with patient satisfaction and quality of life in LASIK

Jara

Erickson

Erickson³

et al. 2011

Eye

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Purpose The aim of this study was to determine how laser in situ keratomileusis (LASIK) affects quality of life (QOL) and to identify factors that may affect satisfaction after LASIK. Methods A total of 104 patients with a mean age of 29±6, treated with LASIK for myopia and astigmatism, were enrolled in a prospective study. High (90%) and low (10%) contrast visual acuity (CVA) were measured under photopic and scotopic conditions before surgery and at 3 months later. A multidimensional QOL scale (Institute for Eye Research multidimensional QOL scale), which assesses psychological characteristics, personality traits, cosmesis, frequency, and tolerance to disturbing visual and ocular symptoms, and overall satisfaction with vision correction, was also used. Paired rank tests were used to compare preoperative and postoperative vision and QOL scores. Correlations and a multiple linear regression were used to describe the relationship between CVA, QOL, and satisfaction after LASIK. Results Significant postoperative changes included increased satisfaction following LASIK (Po0.001), reduced frequency of visual and ocular symptoms (Po0.001), and change in psychological characteristics (P ¼ 0.033). The change in satisfaction with LASIK can be predicted by a combination of preoperative satisfaction, postoperative frequency of disturbing visual and ocular symptoms, postoperative mean spherical equivalent, and postoperative scotopic high CVA (R 2 ¼ 0.725, Po0.05). Conclusions Satisfaction with LASIK is related to visual function, preoperative expectations, psychological characteristics, and uncorrected CVA achieved. An increased sense of subjective well-being, adaptability, and self-efficacy was evident after LASIK. Patients reported a more optimistic attitude to life and increase perceived QOL after surgery.

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“…3 Dry eye symptoms, dissatisfaction with visual outcomes, and burdensome visual symptoms have been reported following LASIK. 4,5 Given the high volume of surgery performed and patient concerns voiced at a public meeting, it is important to evaluate the effect of surgically induced changes on patientreported outcomes (PROs) of LASIK: eye-related symptoms, daily functioning and well-being (health-related quality of life [HRQOL]), and patient satisfaction. [6][7][8] A better understanding of PROs after LASIK may allow eye care professionals and patients to make more educated decisions.…”

mentioning

confidence: 99%

Assessment of the Psychometric Properties of a Questionnaire Assessing Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL)

et al. 2017

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IMPORTANCE Patient-reported outcome (PRO) measures for laser in situ keratomileusis (LASIK) are needed.OBJECTIVE To develop PRO measures to assess satisfaction, eye-related symptoms, and their effect on functioning and well-being following LASIK based on patient and expert input. DESIGN, SETTING, AND PARTICIPANTSThe Patient-Reported Outcomes With LASIK (PROWL) studies were prospective observational studies of patients undergoing LASIK surgery for myopia, hyperopia, or astigmatism. PROWL-1 was a single-center study of active-duty US Navy personnel and PROWL-2 was a 5-center study of civilians. PROWL-1 enrolled 262 active-duty service personnel and PROWL-2 enrolled 312 civilians 21 years or older who spoke English; 241 individuals in PROWL-1 and 280 in PROWL-2 completed a baseline questionnaire before surgery. The analytic sample included those also completing 1 or more follow-up questionnaires: 240 (99.6%) of those in PROWL-1 and 271 (94.4%) of those in PROWL-2. Questionnaires were self-administered through the internet preoperatively and at 1 and 3 months postoperatively in both studies and at 6 months postoperatively in PROWL-1.

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Referrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: Reasons for patient dissatisfaction

Cited by 75 publications

References 15 publications

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) Studies

Visual and non-visual factors associated with patient satisfaction and quality of life in LASIK

Assessment of the Psychometric Properties of a Questionnaire Assessing Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL)

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