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Surprise! Your Patient Still Has Issues After Refractive Surgery

Posted by Ilena Di Toro | Posted on July 31, 2018

Refractive surgery is great, isn’t it? It can allow patients with myopia and cataracts to achieve close to perfect vision.

As good as it is, even refractive surgery has its downsides. Any time there are problems, there will also be complaints from patients. You can’t make all patients happy all the time, but you can take steps to manage patient expectations.

Comanage, Comanage, Comanage
Optometrists and ophthalmologists need to work together in managing the patient. It is especially important for optometrists to provide ophthalmologists with accurate measurements of the cornea. It is also important for the optometrists to provide information about the patient’s eye health and visual needs.

Measure and Examine More than Once
Biometry isn’t exactly exciting, but getting the right measurements and checking them over and over will go a long way achieving a good surgical outcome. Check the patient’s records for the axial length and corneal measurements and measure them again. Maybe nothing has changed between measurements, or maybe something has. The only way to find out is to do the measuring more than once.

Remember, It’s Surgery
This procedure isn’t as simple as having drops put in someone’s eyes. Refractive surgery is surgery and the patient must realize this fact. Every surgery from open heart to wisdom tooth extraction has its risks and complications. The patient has to do his or her homework to learn about the procedure and find a surgeon that meets his or her needs before agreeing to undergo the procedure. The surgeon has his or her work to do, as well. The surgeon needs to take time to learn about the patient’s expectations and explain what may or may not happen.

Encourage the Patient to Bring Someone Along to the Consultation
Having an extra set of ears will help keep patient expectations in check. Encourage the patient to bring a friend or family member along to take notes. Many times, patients apply the experience of others they know that have had refractive surgery, even when their situation is different. That’s where having an extra set of ears comes in handy. The other person isn’t having the surgery done, so he or she can remind the patient about things the surgeon said and be voice of reason.

Realize That the Unexpected will Happen
Sometimes the patient won’t heal as expected or there will be other post-operative developments such as the patient having trouble reading a menu or the screen of a cell phone. If healing doesn’t go as planned, remind the patient that sometimes an enhancement needs to be made after the surgery. Three percent of refractive surgery patients need enhancements. Statistically, if you do enough surgeries, you will have some follow up work to do.

Encourage Patience with Your Patients!
Getting back to the fact that refractive surgery is surgery, results won’t be as instantaneous as putting on a pair of glasses. Some intraocular lenses take as long as six months to settle. Alleviate your patient’s concerns by answering any and all questions, listening, and educating them about the postoperative experience. Results do vary.

As great as refractive surgery is, there is no guarantee of a perfect outcome. That makes the steps you take before and sometimes after surgery all the more important. While you can’t please all patients all the time, you can take steps to minimize the likelihood of unpleasant surprises.

Sources:
https://www.healio.com/optometry/cataract-surgery/news/blogs/%7B34fce4b0-d0a5-436c-8889-af1d72757fba%7D/josh-johnston-od-faao/blog-toward-fewer-bad-surprises

https://www.aao.org/eyenet/article/minimize-surprise-after-refractive-surgery

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