Patient Preparation and Informed Consent
When planning cataract surgery, the surgeon must evaluate the patient’s ability to adhere to the postoperative care regimen. The surgeon should inform the patient (and caregivers, if appropriate) of the importance of using prescribed medication, maintaining proper ocular hygiene, and keeping required appointments. It is helpful to provide written instructions, along with appropriate illustrations or video presentations, and include a family member or friend in preoperative discussions in order to reinforce the patient’s memory. It is important to inform the patient about any activity restrictions during the immediate postoperative period, although the advent of small-incision surgery has significantly minimized these limitations. The surgeon should also assess the patient’s ability to function with only the fellow eye in the event that vision rehabilitation of the surgical eye is prolonged.
The surgeon must obtain informed consent preoperatively. Before deciding to proceed with cataract surgery, it is important to make sure that the patient has a clear understanding of the indications for surgery, the risks and benefits, the alternatives to surgery, the surgical technique, and IOL options. It is also important that the patient understands the anesthesia plan, as discussed in the following section. The surgeon should identify any risk factors for decreased visual outcome, including any preexisting ocular conditions that could adversely impact the result. In addition, the surgeon and patient should discuss the anticipated postoperative refractive status, the limitations of pseudophakic correction, and the proposed date for providing the final optical correction.
It is important that any costs associated with the surgery (eg, those related to medications or the use of premium IOL implants) are clearly outlined preoperatively. In addition, if comanagement with an optometrist or another ophthalmologist is planned, the patient must be explicitly notified and must give consent in writing.
American Academy of Ophthalmology Cataract/Anterior Segment Panel, Hoskins Center for Quality Eye Care. Preferred Practice Pattern® Guidelines. Cataract in the Adult Eye—2016. American Academy of Ophthalmology; 2016. www.aao.org/ppp
American Academy of Ophthalmology. Comprehensive guidelines for the co-management of ophthalmic postoperative care. American Academy of Ophthalmology website. Published 2016. Accessed February 3, 2020. www.aao.org/ethics-detail/guidelines-comanagement-postoperative-care
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.