Impact of Informed Consent on Decision Making for Cataract Surgery at Teaching Hospital University of Lahore
Keywords:
Cataract surgery; informed consent; shared decision-making; patient education; physician–patient communication; ophthalmology; Pakistan.Abstract
Background: Cataract is the leading cause of reversible blindness worldwide, and informed consent is essential for ensuring patient understanding, promoting shared decision-making, and improving satisfaction with surgical care. However, evidence regarding patients' perceptions of the informed consent process in cataract surgery remains limited in Pakistan. Objective: To evaluate the association between informed consent and decision-making among patients undergoing cataract surgery at a tertiary care teaching hospital. Methods: A hospital-based descriptive cross-sectional study was conducted in the Department of Ophthalmology, Teaching Hospital, University of Lahore, Pakistan, between January 2025 to June 2025. A total of 115 adult patients scheduled for cataract surgery were recruited using consecutive sampling. Data were collected through face-to-face interviews using a structured questionnaire assessing demographic characteristics, knowledge of cataract surgery, physician counselling, trust in the treating ophthalmologist, satisfaction with preoperative information, and confidence in treatment decisions. Data were analyzed using SPSS version 27. Descriptive statistics were reported as frequencies and percentages. Results: All 115 eligible participants completed the survey (response rate: 100%). Most participants correctly identified cataract as the cause of their visual impairment (64.3%) and understood that untreated cataract could result in significant vision loss (70.4%). Ophthalmologists were the primary source of information for 62.6% of participants, while 67.0% reported receiving an adequate explanation of the surgical procedure before consent. High levels of trust in the treating ophthalmologist (66.1%), satisfaction with preoperative counselling (60.0%), and confidence in treatment decisions (63.5%) were observed. Furthermore, 63.5% reported that physician counselling had a major influence on their decision to undergo cataract surgery, and 53.0% indicated that they would proceed with surgery despite awareness of potential complications. Conclusion: Most patients reported positive experiences with the informed consent process, including satisfactory counselling, high physician trust, and confidence in treatment decisions. Nevertheless, gaps in patients' understanding of surgical risks highlight the need to strengthen preoperative counselling and standardize informed consent practices to support informed decision-making in cataract surgery. Keywords: Cataract surgery; informed consent; shared decision-making; patient education; physician–patient communication; ophthalmology; Pakistan.
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