Measuring the outcome of cataract surgery: the importance of the patient perspective

12 COMMUNITY EYE HEALTH JOURNAL | VOLUME 28 ISSUE 89 | 2015 Most eye care staff have had the pleasure of removing the pad from a patient’s eye after cataract surgery and seeing their joy at having their sight restored. However, when the outcome of cataract surgery is discussed prior to surgery, the first thing most people think about is visual acuity or complications. Whilst these are critically important, they are only part of the story. Imagine the following scenario. An 85-year-old woman presents with a visual acuity of ‘hand movements’ and dense white cataract in both eyes. She is advised to have cataract surgery. Cataract surgery in the first eye goes well with excellent technical success (a perfect capsulorrhexis, good centration of the intraocular lens, etc.) and her visual acuity improves to 1/60 in her operated eye. Is this a good outcome? From a technical point of view it is – the surgery went well. However, from a visual acuity perspective, it is not ideal as the woman continues to have poor vision in the operated eye. What we don’t know, is what the woman thought about the outcome. Was she happy? If not, why not?