Patient Perspectives and Concerns Regarding Cataract Surgery and Cataract Surgery Sedation: A Qualitative Study

Given the low inherent risk posed by modern cataract surgery, there is ongoing debate regarding the need for anesthesia personnel for this procedure. However, few studies report patient perspectives about cataract surgery sedation. We sought to characterize patient perspectives regarding their experiences undergoing cataract surgery with monitored anesthesia care (MAC) and their willingness to consider cataract surgery with sedation alternatives to MAC.

Semi-structured interviews were conducted with 9 patients (4 women) who recently underwent routine cataract surgery at the University of California, San Francisco. Participants were recruited from the Parnassus Outpatient Surgery Center. Interviews were recorded, de-identified, transcribed, and analyzed using an inductive thematic analysis approach. We ascertained the most relevant themes related to patients' experience with cataract surgery and their perspectives on alternatives to anesthesia-led sedation during routine cataract surgery.

We found that patients are most concerned about achieving the best surgical outcome due to the importance they placed on preserving their vision. They expressed their fear of disrupting surgery intraoperatively and shared that they experienced a relative lack of communication about sedation in advance of surgery. However, while patients expressed a strong preference for anesthesia-led sedation during cataract surgery, they conveyed their openness to considering sedation alternatives in the presence of appropriate perioperative education, the availability of recent evidence supporting the safety of alternative approaches for cataract surgery, and their strong trust in their ophthalmologist's professional recommendations.

Patients prefer anesthesia-led sedation for cataract surgery but are willing to consider alternatives to MAC if the published evidence and their ophthalmologist attest that the alternatives are safe and effective.