Factors influencing outcome satisfaction after cataract surgery: patient-reported insights from the RayPro database.

Background: Patient-reported outcome measures (PROMs) have become crucial in assessing cataract surgery, especially with increasing patient expectations. The RayPro database offers a platform for tracking PROMs after surgery. The purpose of this study is to investigate determinants of patient satisfaction following cataract surgery by analysing PROMs.

Methods: A multicentre, retrospective, observational study was conducted analysing the PROMs recorded in the RayPro database (Rayner, Worthing, UK) from May 2019 to February 2024. Inclusion criteria were age ≥ 18 years, uneventful cataract surgery, valid consent to the study, and at least 1 questionnaire response. Email questionnaires were sent at 1 week, 3 months, and 12 months postoperatively, in which patients scored their outcome satisfaction, surgeon and hospital satisfaction, spectacle independence, and dysphotopsia on a 0-10 scale. Correlations of PROMs with outcome satisfaction were determined for the overall cohort and for eyes categorized by type of implanted intraocular lens (IOL).

Results: 2589 patients (2589 eyes) from 119 hospitals (26 countries) were included. Outcome satisfaction showed strong to moderate negative correlation with daytime and nighttime dysphotopsia at 3 months (r=-0.522, p < 0.001; r=-0.430; p < 0.001, respectively), strengthening at 12 months (r=-0.609, p < 0.001; r=-0.541; p < 0.001, respectively). Outcome satisfaction showed weak to no correlation with spectacle independence for distance, intermediate, and near vision at 3 months (r = 0.209, p < 0.001; r = 0.160, p < 0.001; r = 0.071, p = 0.007, respectively). Similar correlations between outcome satisfaction and dysphotopsia and between outcome satisfaction and spectacle independence were observed in monofocal as well as presbyopia-correcting IOLs. In the overall cohort, surgeon and hospital satisfaction at 1 week were strongly correlated with each other (r = 0.592, p < 0.001), while both were moderately correlated with outcome satisfaction at 3 months (r = 0.344, p < 0.001; r = 0.339, p < 0.001, respectively) and 12 months (r = 0.307, p < 0.001; r = 0.314; p < 0.001, respectively).

Conclusion: Dysphotopsia was strongly correlated with patient dissatisfaction, and the correlation strengthened over time. Outcome satisfaction was weakly correlated with spectacle independence, and moderately correlated with surgeon and hospital satisfaction. Thus, postoperative visual quality and quality of care provided by surgeon and hospital can influence patient satisfaction.