EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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E W CATARACT 68 March 2014 the procedure itself and the recovery period," he said. It may be just as important to tell patients what to e xpect prior to surgery and give them anxiety-reducing techniques they can use while waiting for surgery, he added. The study shows the importance of patient education before cataract surgery, Mr. Kekecs said. However, ophthalmologists and their staff members will want to be careful h ow they phrase this information, as some patients want to deliberately avoid information about surgery, thinking that if they know what will happen to them, it will increase their anxiety, Mr. Kekecs said. Oliver Findl, MD, Department of Ophthalmology, Hanusch Hospi- tal, Vienna, Austria, found the study i nteresting, but he does see patients from time to time who do not want to know what he's going to do in the operating room. Dr. Findl has been involved with previous research that included a video to prep cataract patients pre- operatively and found that anxiety levels were lowered if patients had a better idea of what to expect, al- though the difference was marginal. He also was co-author of a 2012 study in the Journal of Cataract & Refractive Surgery that involved a c omputer-based tutorial prior to surgery in addition to the traditional informed consent process. 2 The in- tervention group was significantly better informed than the control group, which only had conventional informed consent. However, Dr. Findl said that for people who are very anxious, there m ay be no intervention to truly change how they are feeling. He also said he liked the idea of the audio CD used in the study but that cataract surgery patients who are older may not always be receptive to positive imagery techniques and suggestions. Dr. Findl finds it helpful during s urgery to verbally reassure patients that they are doing well and to pre- pare them for what sensations they might feel or when something in the room, such as the lighting, will change. "About 25% of patients will say, 'Thanks for talking with me dur- ing that, it was relaxing,'" he said. Health literacy educator Jann Keenan, EdS, president, The Keenan Group, Ellicott City, Md., said the intervention in Mr. Kekecs' study worked well for several reasons. First—"Hearing the physician's voice o n the CD and then having the same physician perform the surgery built trust," she said. Second, pa- tients had the relevant educational information read to them, so there was no concern over how well a patient could read. However, Ms. Keenan said that some words used in the script, such as forefront, d ilated, anesthetized, and bacteria, could be changed to easier terms for even stronger comprehension for all. Ms. Keenan said that the use of an audio CD along with a brief, easy-to-read brochure that discusses surgical success rates and outlines everything to expect before, during, and after surgery would make the e ducational effort even more effec- tive. She also encouraged cataract surgeons to use the teach-back tech- nique—asking patients open-ended questions that require them to ex- plain in their own words the health information given to them in order to determine whether it was pre- sented in a way they understand. Mr. Kekecs said he and fellow investigators have six-month data from the patients in this study; although the data are not yet ready for publication, it appears t hat the intervention group patients experienced some long-term benefits compared with the control group. EW References 1. Kekecs Z, Jakubovits E, Varga K, Gombos K. Effects of patient education and therapeutic suggestions on cataract surgery patients: A r andomized controlled clinical trial. Patient Education and Counseling. 2014;94:116-122. 2. Wollinger C, Himschall N, Findl O. Computer-based tutorial to enhance the quality and efficiency of the informed-consent process for cataract surgery. J Cataract Refract Surg. 2012;38;655-659. Editors' note: The sources have no f inancial interests related to this article. Contact information Findl: oliver@findl.at Kekecs: kekecs.zoltan@gmail.com Keenan: jann@healthliteracyworks.com Patients deserve optimal visual quality and functional visual acuity in all light conditions C-flex ® Aspheric IOL with aberration-neutral technology: An IOL made from optically pure, superior quality material: 1. Kohnen T et al. Ophthalmologe 2008; 105(3): 234-40. 2. Nanavaty MA et al. JCRS 2009; 35(4): 663-71 3. Lyall DAM, Srinivasan S, Gray LS. Optom Vis Sci 2013; 90(9):996-1003. 4. Johansson B et al. JCRS 2007; 33: 1565-1572. 5. Altmann GE et al. JCRS 2005; 31(3): 574-585. 6. Erie JC, et al JCRS 2001; 27:614-621. 7. Rayner. Data on File. White paper. P Rayner C atients deserve optimal visual quality and functional - Rayner C flex Hydrophilic acrylic enhanced monofocal IOL atients deserve optimal visual quality and functional flex ® Aspheric Hydrophilic acrylic enhanced monofocal IOL atients deserve optimal visual quality and functional Aspheric Hydrophilic acrylic enhanced monofocal IOL atients deserve optimal visual quality and functional atients deserve optimal visual quality and functional P visual acuity in all light conditions C-flex Offers improved contrast sensitivity and visual acuity • compared with spherical IOLs Can offer 50% more depth of field than aberration-negative IOLs, by retention of the • atients deserve optimal visual quality and functional visual acuity in all light conditions flex ® Aspheric IOL with aberration-neutral technology: Offers improved contrast sensitivity and visual acuity compared with spherical IOLs Can offer 50% more depth of field than aberration-negative IOLs, by retention of the atients deserve optimal visual quality and functional visual acuity in all light conditions Aspheric IOL with aberration-neutral technology: Offers improved contrast sensitivity and visual acuity compared with spherical IOLs 1,2,3 Can offer 50% more depth of field than aberration-negative IOLs, by retention of the atients deserve optimal visual quality and functional visual acuity in all light conditions Aspheric IOL with aberration-neutral technology: , particularly in low light conditions Offers improved contrast sensitivity and visual acuity Can offer 50% more depth of field than aberration-negative IOLs, by retention of the atients deserve optimal visual quality and functional , particularly in low light conditions Can offer 50% more depth of field than aberration-negative IOLs, by retention of the Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration Less susceptible to the effects of tilt and decentration than aberration-negative IOLs • An IOL made from optically pure, superior quality material: • Low refractive index (1.46) of Ray ree from vacuoles and glistenings • F Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration Less susceptible to the effects of tilt and decentration than aberration-negative IOLs An IOL made from optically pure, superior quality material: • Low refractive index (1.46) of Ray ree from vacuoles and glistenings Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration Less susceptible to the effects of tilt and decentration than aberration-negative IOLs An IOL made from optically pure, superior quality material: • Low refractive index (1.46) of Rayacryl ® reduces the risk of glare ree from vacuoles and glistenings 7 Can offer 50% more depth of field than aberration-negative IOLs, by retention of the patient's natural level of positive corneal spherical aberration 4 Less susceptible to the effects of tilt and decentration than aberration-negative IOLs An IOL made from optically pure, superior quality material: reduces the risk of glare 6 Can offer 50% more depth of field than aberration-negative IOLs, by retention of the Less susceptible to the effects of tilt and decentration than aberration-negative IOLs 5 .com rayner ohnen T et al. Ophthalmologe 2008; 1. K 27 . Data on File. White paper :614-621. 7. Rayner .com ohnen T et al. Ophthalmologe 2008; 105(3): 234-40. 2. Nanavaty MA et al. JCRS 2009; 35 . . Data on File. White paper 35 AM, Srinivasan S, Gray LS. Optom Vis Sci 2013; yall D (4): 663-71 3. L AM, Srinivasan S, Gray LS. Optom Vis Sci 2013; 90(9):996-1003. 4. Johansson B et al. JCRS 2007; (9):996-1003. 4. Johansson B et al. JCRS 2007; 33: 1565-1572. 5. Altmann GE et al. JCRS 2005; 31 31(3): 574-585. 6. Erie JC, et al JCRS 2001; Help continued from page 66 64-75 Cataract_EW March 2014-DL2_Layout 1 3/6/14 3:10 PM Page 68