Cataract surgery and consent

Abstract

Purpose: To assess patients' recall of information, anxiety, and attitude toward trainee surgeons immediately after providing consent for cataract surgery and 1 month postoperatively. Setting: Cataract Clinic, Princess Alexandra Eye Pavilion, Edinburgh, Scotland. Methods: A questionnaire was administered to 51 patients immediately after their consent was obtained at the preassessment clinic and 1 month postoperatively (50 patients). Anxiety, attitude toward trainee surgeons, and difficulty understanding the cataract surgery consent and information form were assessed using visual analog scales. Results: Nine postconsent patients (18%) and 2 postoperative patients (4%) recalled the risk for major complications. All postconsent and 40 of 47 postoperative patients (85%) who remembered signing the consent form said they believed they were adequately informed. Patients reported little anxiety about surgery; the consent process had no effect on this. Five of 17 postconsent patients (29%) and 7 of 23 postoperative patients (31%) who could not recall being told a trainee might perform their procedure were unhappy; 1 patient in each group (3% and 4%, respectively) who could recall such a discussion were unhappy. Conclusions: Patient recall of specific details related to cataract surgery was poor immediately after consent was obtained and deteriorated postoperatively. Despite this, most patients reported they were well informed about surgery and had little anxiety. Patients accept the need for surgical training if they recall a discussion of this at the time of consent. If they do not, many are very unhappy regardless of surgical outcome. These findings strongly support an explicit discussion of surgical training as part of the consent process.