Patients with worse vision after laser surgery are more likely to report outcomes

A study was conducted to determine which factors may influence patients to complete patient-reported outcome (PRO) measure questionnaires following laser vision correction surgery.

Study design

This was a retrospective, population-based study of all patients who underwent primary laser vision correction at a U.S. refractive surgery center during a 2-year period. The main outcome measure was the number of patients who completed a PRO measure, based on the Patient Reported Outcome with LASIK study questionnaire. Investigators compared the characteristics and outcomes of patients who did and did not complete the measure.

Outcomes

Out of 37,043 patients, 20,501 completed the PRO measure at the 1-month postoperative visit and 10,474 completed the measure at the 3-month postoperative visit. Patients who completed the PRO measure had worse objective visual outcomes than patients who did not; for every line of visual acuity that was worse than 20/16, the odds ratio of completing the measure was 1.33 at 1 month following surgery and 1.16 at 3 months following surgery. In general, patients who completed the PRO measure were more likely to be older, to have undergone a photorefractive keratectomy, and to require  preoperative hyperopic correction; those who completed the measure at 3 months had a greater likelihood of preoperative hyperopia or myopia.

Limitations

As with any questionnaire-based study, subjective factors not in the control of the provider may have affected patient satisfaction scores and could have biased the results.

Clinical significance

This study demonstrated that patients who completed a PRO questionnaire following laser vision surgery were more likely to have worse visual outcomes, including residual visual error, than patients who did not complete the questionnaire. Providers may potentially use these data to devise methods of encouraging patients to report postsurgical outcomes.