Patients who undergo cataract surgery can benefit from preoperative target refraction discussions, postoperative refraction management, and driving advice from their optometrist, according to an investigation published in Ophthalmic & Physiological Optics. However, less experienced optometrists are less likely to advise their patients on these matters, the report suggests.
Researchers conducted a 2-round Delphi study which included a team of optometrists (n=11; 55% women) and ophthalmologists (n=11; 18% women). Three team members proposed a list of 18 suggestions based on areas of concern voiced by focus groups. Panel members expressed agreement with the recommendations using a 5-point Likert scale (1, strongly disagree; 5, strongly agree) and suggested any amendments to the recommendation they felt were necessary. Moderate to strong agreement among 80% or more of the panel members indicated consensus for an item and enabled it to proceed to the next round.
A total of 95% (n=21) of participants indicated that optometrists should provide target refraction advice and postoperative refraction management to their patients. However, time constraints and the surgeon’s role in determining the final refractive outcome were identified as 2 reasons many optometrists expressed hesitancy to engage in these discussions with their patients. The report also shows that optometrists with less experience were less likely to discuss target refraction and suggests that these eye care professionals could benefit from guidance in these clinical decisions.
“Fifteen recommendations reached consensus after 2 rounds of the Delphi method using a panel of experienced optometrists and ophthalmologists,” according to the study authors. “They support optometrists playing a role in the provision of information regarding target refraction and postoperative refractive management of patients with cataract. Implementing these recommendations in practice could both remediate areas of concern for patients, help optometrists with their clinical decisions and discussions and may be of particular benefit to less experienced optometrists.”
Study limitations include a potential for volunteer bias and a limited number of rounds using the Delphi method.
Charlesworth E, Ursell P, Ho KC, Keay L, Elliott DB. Developing refractive management recommendations for patients undergoing cataract surgery: a Delphi study. Ophthalmic Physiol Opt. Published online November 16, 2022. doi:10.1111/opo.13069