Original Article

 

A Survey of Patient Satisfaction with LASIK

 

Sharmeen Akram, Maheen Akhter Syed, Salim Mahar, Salman Naveed Sadiq, Fatima Naqvi

 

Pak J Ophthalmol 2017, Vol. 33, No. 2

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See end of article for

authors affiliations

 

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Correspondence to:

Sharmen Akram

Aga Khan University Hospital

Karachi

Email: sharmeen.akram@aku.edu

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Purpose: To assess patient satisfaction following laser in situ keratomileusis (LASIK).

Study Design: Descriptive, cross-sectional study.

Place and Duration of Study: Laser vision Center, Karachi, from Jan 2012 to April 2016.

Material and Methods: All patients who underwent LAISK procedure in one or both eyes by two surgeons from Jan 2012 to April 2016 at a refractive center (Laser Vision) in Karachi and agreed to participate in the survey were included. These patients were surveyed telephonically to establish their degree of satisfaction with LASIK and to enquire about postoperative use of glasses, and symptoms of night vision problems and if they would recommend this procedure to others. Patient anonymity was assured. Descriptive statistics were calculated using SPSS version 19.

Results: A total of 52 people who had undergone LAISK procedure in one or both eyes were interviewed. 12 (23.1%) were males and 40 (76.9%) were females. Their mean age was 29.83 ± 5.14 years. In our survey, the overall spectacle independence for distance was 90.4%. Visual disturbance was reported by 19.2% of participants. The satisfaction level of patients post Lasik was 86.5%.

Conclusion: Our results are comparable to worldwide studies, which also show a high post- Lasik patient satisfaction.

Key words: LASIK, patient satisfaction, spectacle independence, surveys

 

L

Laaser In Situ Keratomileusis (LASIK) surgery is one of the most common refractive procedures performed in developed countries where more than half of the adult population has refractive errors1. Its popularity is due to its pain-free nature, early visual recovery, predictability of results and low rate of complications2-6. Multiple studies have been conducted regarding patient satisfaction after Lasik procedure17-12. In order to understand patient satisfaction due to this procedure various factors contributing to it must be looked at such as unaided vision, improved cosmetic appearance, better participation in sport and other daily activities9,13.

        To our best of knowledge no such study has been documented in Pakistan. The aim of this study was to assess patient satisfaction after LASIK procedure performed at a refractive center in Karachi.

 

MATERIAL AND METHODS

This was a cross-sectional survey. All patients, aged 20 years or older and of either gender, who underwent LAISK procedure in one or both eyes by two surgeons from Jan 2012 to April 2016 at a refractive center (Laser vision) in Karachi were included in this study. After obtaining informed verbal consent, a structured telephone interview was conducted with the participants to collect data on socio-demographics (age, gender, occupation), spectacle/contact lens use(pre and post Lasik), visual disturbances such as halos, starburst and glare (pre- and post-Lasik) and satisfaction (satisfied/not satisfied). Of the two hundred patients called, only 52 patients agreed to be interviewed.

        IBM SPSS Statistics version 19 (Statistical Package for Social Sciences) was used to enter and analyze the data. This was a descriptive analysis. Means and SDs were calculated to describe quantitative data. Counts and proportions were computed to describe categorical data.

 

RESULTS

A total of 52 people were interviewed. Their mean age was 29.83 ± 5.14 years (range 20-50 years).  12 (23.1%) were males and 40 (76.9%) were females. An overall spectacle independence for distance was reported to be 90.4% (Table 1). Visual disturbance such as halos, starburst and glare post Lasik was reported to be 19.2 %. Daily activities post Lasik got affected in 21.2% of the patients. However, the overall satisfaction level post-Lasik was 86.5% (Table 1) and in spite of daily activities being affected, many participants were satisfied (Table 2). Overall 88.5% participants said they would recommend LASIK surgery to others (Figure 1).

 

Table 1:   Spectacle independence, visual disturbance, effect on daily activities and patients’ satisfaction after LASIK surgery (n = 52).

 

Characteristic

Frequency

Percent

Spectacle independence

 

 

Yes

47

90.4

No

  5

9.6

Visual disturbance

 

 

Yes

10

19.2

No

42

80.8

Daily activities

 

 

Not effected

41

78.8

Affected

11

21.2

Satisfaction

 

 

Satisfied

45

86.5

Not satisfied

  7

13.5

 

DISCUSSION

Multiple studies have been reported on patient satisfaction and various surgical procedures. Eye being one of the six senses patient, satisfaction, following any eye surgery is of utmost importance. As refractive surgery especially the Lasik procedure deals with normal eye, the satisfaction level assessment becomes very important following this procedure. The LASIK surgery is a safe procedure but not risk free and rare complications when reported by a small number of dissatisfied patients can give an unbalanced negative attitude about the surgical procedure14-16. Therefore to evaluate genuine patient satisfaction many surveys have been done1,7,8,17-20.

 

Table 2:   Satisfaction among those whose daily activities got affected.

 

Characteristic

Satisfaction

P*

Satisfied

Freq (%)

Not Satisfied

Freq (%)

Daily activities

Un-affected

38 (92.7)

3 (7.3)

0.029

Got affected

7 (63.6)

4 (36.4)

 

*P-value calculated using Fisher's exact test

 

 

Figure 1:  When asked if they would recommend LASIK to others (n=52).

 

        It is important to understand the various reasons for the satisfaction post- Lasik such as unaided good vision, cosmesis1,12,13,21. Current estimates of patient satisfaction with LASIK range from 82% to 98%17,19. Our study showed 86.5% patient satisfaction post- Lasik, with 88.5% of the patients willing to recommend the procedure (Figure 1).

        19.2% patient reported visual disturbances such as halos, starburst and glare, similar symptoms were also reported in other studies in the range of 12-57% of patient18,22. In spite of these symptoms, the satisfaction levels remained high 84.6%.

        In our study 90.4% of the patients reported spectacle independence which was the main factor for patient satisfaction-after the procedure. Various reasons for patient satisfaction have been discussed in different studies; an unaided vision seems to be one of the most important factors7,12.

        Factor creating bias in such a study is when the physician administers satisfaction questionnaires. To minimize this bias the survey was conducted by a resident and a medical student.

        Limitations to our study were that the survey was done over a long follow up period. Long-term follow-up results in difficult recall in accurately comparing the patient’s preoperative and present quality of vision. Another limitation of our study is that objective quantification of night vision problems is still a challenge and limits accuracy study results. 19.2% of our patients reported visual disturbances however in spite of this satisfaction level was high and daily activities were not affected in most. Our results are comparable to worldwide studies, which also show a high post- Lasik patient satisfaction.

 

ACKNOWLEDGEMENT

Laser Vision Centre.

 

Author’s Affiliation

Dr. Sharmeen Akram

MBBS, FCPS

Assistant Professor

Aga Khan University Hospital

Karachi

 

Dr. Maheen Akhter Syed

MBBS

Resident

Aga Khan University Hospital

Karachi

 

Dr. Salim Mahar

MBBS, FRCOphth, FRCS

Senior Lecturer

Aga Khan University Hospital

Karachi

Dr. Salman Naveed Sadiq

MBBS

Resident

Aga Khan University Hospital

Karachi

 

Dr. Fatima Naqvi

Student

Medical College, Aga Khan University Hospital

Karachi

 

Role of Authors

Dr. Sharmeen Akram

Study design, manuscript drafting and critical review.

 

 

Dr. Maheen Akhter Syed

Study design, data collection, and critical review.

 

Dr. Salim Mahar

Manuscript drafting and critical review.

 

Dr. Salman Naveed Sadiq

Manuscript drafting and critical review.

 

Dr. Fatima Naqvi

Study design, data collection, and critical review.

 

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