Patients’ Expectations in Lens Extraction Surgery: a Systematic Review

It is common knowledge that there are patients who have an uncomplicated cataract surgery with an actual improvement of their visual acuity, but they are dissatisfied with their final visual capacity. It is hypothesized that patients’ preoperative expectations play a significant role in their postoperative perceptions. A systematic review of the recent literature regarding preoperative expectations of patients before lens extraction surgery and their postoperative perceptions as regards the visual outcome was performed based on the PubMed, Medline, Google Scholar, American Academy of Ophthalmology, Nature and Springer databases in September 2017 and data from 14 descriptive and 7 comparative studies were included in this narrative review. The objective of this review is the determination of the relationship between preoperative expectations and postoperative perception of visual outcome, as well as the investigation of predictors of patient satisfaction by understanding the factors that determine preoperative patient expectations. A considerable number of studies evaluate patient expectations before cataract surgery and compare them with postoperative patient perceptions. In conclusion, the final patient’s postoperative perception could be affected both by the actual outcome of the operation and by patient preoperative expectations. Ocular and systemic comorbidity, unrealistic expectations, preoperative spectacle independence, the cost of surgery, and a previous cataract surgery as well as the level of health literacy and age could influence preoperative expectations and predict more accurately patient satisfaction. Taking these factors into consideration could allow surgeons to control the expectations with an extensive preoperative counseling.