Predictors of long-term cataract surgical patient satisfaction found in cell-phone follow-up in a primarily Tibetan region of China

Abstract:

AIM:To evaluate predictors of patient satisfaction with vision and comfort following cataract surgery in Kandze Prefecture People's Hospital, in Dartsedo, the capital of a Tibetan region of China.

METHODS:Prospective observational study of all patients undergoing cataract surgery in Kandze Hospital in 2012. Patients categorized in terms of ocular pathology and/or surgical complications at discharge, were contacted at 3mo postoperatively by cell-phone to determine satisfaction with vision and presence of discomfort.

RESULTS:In 2012, Kandze Hospital conducted 888 cataract operations on 678 patients, 364(54%)women. Most patients(93%)presented with severe visual impairment or blindness(<6/60)in the better eye. Among the 881 eyes, the main surgical complications were corneal edema(44 cases)and vitreous loss(19 cases)while the main pathologies were retinal disorders(30 cases)and “old” iritis(11 cases). At 3mo, 508(75% of 678 cataract patients)were contacted at least once by cell-phone. Of the 588 eyes self-assessed, 485(82%)were reported “better”, 85(15%)“same”, and 18(3%)“worse” than the time of discharge for discomfort, visual acuity, or both. Significantly more eyes “with pathology” compared with “neither pathology nor complications” at discharge were reported to have discomfort or poor vision at 3mo(Chi-square=6.575, P=0.037).

CONCLUSION:The need forcataract surgical patient follow-up advice at 3mo is predictable at discharge and increasingly possible with cell-phone technology. However, the ability to assist patients with complications or ocular pathology depends on improving eye care services in the region.

Key words:cataract surgery; visual outcome; patient satisfaction; Tibetan region