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Sir, Ophthalmologists have an ethical and legal obligation to give a fully informed consent so that the patients can make an intelligent decision prior to cataract surgery.1 Serious errors

in patient's understanding and recollecting the information given pre-operatively can lead to medical malpractice litigations.2 This prospective study was undertaken to determine the

percentage of preoperative information, about cataract and cataract surgery-related complications surgery, retained on the day of surgery. In all, 82 patients undergoing elective

phacoemulsification with intraocular lens implantation were included in this study. At 2 weeks prior to the operation, each patient received a standardised written and verbal explanation

about cataract surgery and the possible complications. There were 55 patient's undergoing surgery for the first eye and 27 for the second eye. A study questionnaire was designed to

check patient's recall of preoperative information provided on the day of surgery. A trained nurse read out the questionnaire for patient's who had difficulty reading it.

Questions, phrasing, and intonation were standardised to avoid any bias. Also, all the questions included a ‘don’t know' option. In all, 92.3% of patients found the combined information

provided by the nurse on pre-operative assessment visit, and through the booklet to be useful. The mean accuracy of correct information recalled was 38.9% in the first eye surgery and even

lower in second eye group at 32.9%. This was surprising as the second group of patients not only had heard the consent before but also had undergone both the preoperative process and the

postoperative course. Patient's recall of information relating to the complications (including infection, haemorrhage, dropped nucleus, blindness and loss of eye) was poor in both the

groups. Patients in our study were questioned on the day of surgery, which is earlier than most of the other studies;3, 4 still the recall of information was poor. It could be argued that

the anxiety provoked on the day of surgery might have prompted them to give wrong answers. However, a previously published study5 has shown that the mean anxiety provoked by cataract surgery

is more on the day of preassessment than on the day of surgery itself. Cognition and memory in this elderly group of patients (mean age 76.6±8.2 years) was not measured. Elderly patients

and impaired cognition have been associated with poor information recall6 and we believe that these factors played a role in poor information recall. Our study shows that patient's

recall minimal of the preoperative discussion. It highlights the importance of ophthalmologists to pursue at exceeding length their patient's education. Verbal and written information

supplied to a patient may be understood, but is easily and quickly forgotten.7 To realise the full potential of informed consent, the preoperative discussion must undergo further changes in

order to avoid any misunderstanding and potential medico-legal litigations. REFERENCES * Cataract Surgery Guidelines. The Royal College of Ophthalmologists, February 2001. * Kraushar MF,

Turner MF, Westfield NJ . Medical malpractice litigations in cataract surgery. _Ophthalmology_ 1987; 105: 1339–1343. CAS  Google Scholar  * Morgan LW, Schwab IR . Informed consent in

cataract surgery. _Arch Ophthalmol_ 1986; 104: 42–45. Article  CAS  Google Scholar  * Priluck IA, Robertson DM, Buettner H . What patients recall of the preoperative discussion after retinal

detachment surgery. _Am J Ophthalmol_ 1979; 87: 620–623. Article  CAS  Google Scholar  * Foggitt PS . Anxiety in cataract surgery: pilot study. _J Cat Refract Surg Oct_ 2001; 27(10):

1651–1655. Article  CAS  Google Scholar  * Lavelle-Jones C, Byrne DJ, Rice P, Cuschieri A . Factors affecting quality of informed consent. _BMJ_ 1993; 306(6882): 885–890. Article  CAS 

Google Scholar  * Turner P, Williams C . Informed consent: patients listen and read, but what information do they retain? _N Z Med J_ 2002; 115(1164): U218. PubMed  Google Scholar  Download

references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Ophthalmology, Leighton Hospital, Crewe, UK N Dhingra, S Clews, M A Neugebauer & A D Hubbard Authors * N Dhingra

View author publications You can also search for this author inPubMed Google Scholar * S Clews View author publications You can also search for this author inPubMed Google Scholar * M A

Neugebauer View author publications You can also search for this author inPubMed Google Scholar * A D Hubbard View author publications You can also search for this author inPubMed Google

Scholar CORRESPONDING AUTHOR Correspondence to N Dhingra. ADDITIONAL INFORMATION Presented as a poster at 15th Congress of Royal College of Ophthalmologists, Birmingham, UK, 2003 RIGHTS AND

PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Dhingra, N., Clews, S., Neugebauer, M. _et al._ What patients recall of the preoperative discussion before cataract

surgery: results of a questionnaire survey. _Eye_ 18, 790–791 (2004). https://doi.org/10.1038/sj.eye.6701420 Download citation * Published: 16 April 2004 * Issue Date: 01 August 2004 * DOI:

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