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Patients’ perspective and experience towards same-day bilateral cataract surgery: A qualitative study
*Corresponding author: Trang Truong Laursen, Department of Ophthalmology, Odense University Hospital, Odense, Denmark. trang.laursen@rsyd.dk
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Received: ,
Accepted: ,
How to cite this article: Laursen TT, Winther C, Thinggaard BS. Patients’ perspective and experience towards same-day bilateral cataract surgery: A qualitative study. Global J Cataract Surg Res Ophthalmol. 2025;4:113-21. doi: 10.25259/GJCSRO_15_2025
Abstract
Objectives:
The purpose of the study is to explore patients’ experiences with same-day bilateral cataract surgery and assess whether this surgical approach aligns with their expectations and satisfaction.
Materials and Methods:
This is a qualitative cross-sectional study using semi-structured telephone interviews conducted at the Department of Ophthalmology, Odense University Hospital, Denmark. Twenty patients who underwent same-day bilateral cataract surgery were interviewed 7–9 days postoperatively. Patients were selected based on their ability to participate in telephone interviews and their willingness to share their experiences. Thematic analysis was conducted to identify key themes related to their perspectives before, during and after surgery.
Results:
A total of 20 patients (40 eyes) participated. Three main themes emerged: (1) Communication – Patients highlighted the importance of clear and empathetic communication from healthcare staff, which contributed to a sense of security and trust. (2) Surgical experience – Despite initial anxiety, patients reported overall satisfaction and valued the convenience of having both eyes treated in one session. (3) Post-operative period – Patients emphasised the benefits of avoiding a second hospital visit and appreciated the efficiency of the procedure.
Conclusions:
Patients expressed high satisfaction with same-day bilateral cataract surgery and a willingness to recommend the procedure. Ensuring effective and compassionate communication before, during and after surgery may enhance the overall patient experience and acceptance of this approach.
Keywords
Cataract
Ophthalmology
Patient perspective
Phacoemulsification
Same-day bilateral cataract surgery
INTRODUCTION
Cataract remains the leading cause of blindness globally, affecting approximately 15.2 million people over the age of 50.[1] The disease is characterised by the clouding of the eye’s lens, leading to symptoms such as blurry vision, difficulty seeing at night and faded colour perception.[2] Cataract commonly develops as part of the ageing process due to protein changes in the lens but can also result from various genetic and environmental factors such as prolonged ultraviolet exposure, eye injury or certain medical conditions such as diabetes.[3] Phacoemulsification is the most common treatment for cataracts in Western countries, involving ultrasound energy to break up the cloudy lens, followed by replacement with an artificial intraocular lens.[4] Cataracts are predominantly age-related, and as the population ages, the need for treatment continues to rise.[2] By 2025, the number of Danes aged over 80 is projected to increase by 80,000 compared to 2023, significantly raising the demand for ophthalmological care including cataract surgery.[5,6] This growth in combination with challenges such as the COVID-19 pandemic has led to increased waiting times for elective cataract surgery.[6,7] In response, healthcare systems have explored innovative solutions, such as same-day bilateral cataract surgery, which reduces waiting times and resource consumption.[8,9] Same-day bilateral cataract surgery is a relatively new approach in Denmark, although it has been practiced for some time in other countries and remains a topic of significant international debate.[10-12] There is a wide agreement that there is a greater financial gain by operating on both eyes on the same day,[13] and studies have determined that the approach is safe in terms of complications such as cystoid macular oedema and endophthalmitis,[14-16] Although evidence suggests that this approach is safe compared to unilateral cataract surgery, there remains limited research focusing on patients’ subjective experiences and perspectives before, during and after same-day bilateral cataract surgery.[17-19] Previous studies have focused on different aspects, such as why patients did not choose same-day bilateral cataract surgery themselves and the challenges related to the inability to adjust the lens calculation plan between the first and second cataract surgeries.[8,9]
Furthermore, studies describing patients’ experiences with unilateral cataract surgery highlight the loss of vision as one of the main sources of anxiety and fear associated with the procedure.[9,19] Therefore, it is important to explore whether same-day bilateral cataract surgery might increase anxiety and fear, as patients may perceive both eyes to be at risk of complications.
The aim of the study is to explore patients’ perspectives and experiences with the same-day bilateral cataract surgery.
MATERIALS AND METHODS
Study design and participants
A qualitative exploratory design was employed to gain insight into the patient’s perspective on the same-day bilateral cataract surgery. Semi-structured telephone interviews were conducted between days 7 and 9 postoperatively. The interviews were used to gain insight into the patients’ perspective and experience of same-day bilateral cataract surgery. The participants described their experience during the pre-, peri- and post-operative stages. Participants (n = 20) were recruited on the day of surgery, where they received oral and written information about the study. Inclusion criteria were (1) patients who were to undergo same-day bilateral cataract surgery under local anaesthesia, (2) able to speak and understand Danish and (3) cognitively well preserved (definition: oriented in time and place aware of personal data/information). The exclusion criteria included (1) patients whose surgery was converted to unilateral during the procedure and (2) patients with moderate-to-severe dementia or those unable to read and sign a written consent form.
The research methodology was guided by Gadamer’s hermeneutics, an epistemological framework that emphasises understanding through interpretation. The two primary investigators (PIs), who conducted the interviews, drew on their pre-existing knowledge and understanding to interpret the data. This interpretation process involved a dynamic interaction between the new insights gained from the interviews and the PI’s prior knowledge, creating a cyclical process known as the hermeneutical circle.[20] With a background as a nurse specialising in ophthalmology and extensive clinical experience, the PIs brought a unique sensitivity to the patients’ perspectives, ensuring a thorough understanding of their experiences. To minimise any bias from their clinical background, the PIs consciously addressed the potential influence of their experience, aiming to avoid any hindrances to the research process.
Procedure
The study was approved by the institutional review board in the Region of Southern Denmark (Record No. 24/7126). According to Danish national regulations, no further ethical approval was required.[21] Participants gave written consent, were informed of their right to withdraw and ensured anonymity. Interview timing was scheduled on surgery day.
Data analysis
Semi-structured telephone interviews were conducted, audio-recorded and transcribed word-for-word by the PIs in February 2024. Open-ended questions were asked during the interviews such as what thoughts did you have in relation to the cataract surgery, can you describe your experience the day you had to undergo surgery and how did you feel after the surgery in relation to your cataract surgery. Specialists developed the interview guide to ensure clinical relevance. Interviews lasted 21–36 min, with anonymity maintained through numerical codes. Data were transcribed and analysed using NVivo 12.
To enhance the study’s trustworthiness, thematic analysis was employed, consisting of six distinct phases.[22] In Phase 1, transcription was carried out by the PIs using the intelligent verbatim method, with the transcripts being read multiple times to ensure familiarity with the content. Phase 2 involved the initial coding of the dataset by both PIs using an inductive approach to group the data into meaningful categories. In Phase 3, a semantic approach was adopted to form initial themes based on the identified codes. The PIs then engaged in discussions to explore the relationships between the codes and themes, leading to the consideration of several potential themes. Phase 4 saw further refinement of these themes through extensive discussions, culminating in the identification of three main themes: (1) Communication, (2) the experience of the surgery and (3) the time after the surgery. In Phase 5, quotes were included to support themes and strengthen findings. In Phase 6, results were presented to address objectives and conclude the study.
RESULTS
Demographic characteristics
We enrolled a total of 20 participants with a median age of 73.5 (ranging from 65 to 87), including 11 females and 9 males. All participants had both eyes treated the same day by four different surgical teams [Table 1].
| Participant ID | Sex | Surgeon operating | Age | Post-operative day for interview |
|---|---|---|---|---|
| PT01 | Female | S3 | 68 | 7 |
| PT02 | Male | S1 | 70 | 7 |
| PT03 | Female | S1 | 79 | 7 |
| PT04 | Male | S1 | 71 | 7 |
| PT05 | Male | S1 | 85 | 7 |
| PT06 | Female | S1 | 75 | 7 |
| PT07 | Female | S1 | 72 | 7 |
| PT08 | Male | S3 | 87 | 7 |
| PT09 | Male | S2 | 77 | 9 |
| PT10 | Female | S4 | 80 | 9 |
| PT11 | Male | S3 | 66 | 9 |
| PT12 | Male | S4 | 66 | 9 |
| PT13 | Female | S4 | 79 | 9 |
| PT14 | Female | S2 | 74 | 8 |
| PT15 | Female | S4 | 81 | 8 |
| PT16 | Female | S4 | 81 | 8 |
| PT17 | Female | S2 | 73 | 8 |
| PT18 | Female | S3 | 69 | 9 |
| PT19 | Male | S2 | 65 | 7 |
| PT20 | Male | S3 | 69 | 9 |
PT: Participant
Main themes
Three main themes emerged from analysing the transcriptions: Communication, the experience of the surgery and the time after the surgery. Every main theme includes two to three subthemes. Table 2 contains the quotes from the study, which are described in the results section. Every quote is categorised under only one theme but can be sense making within several themes.
| Theme | Quote nr | ID no. | Illustrative quotes |
|---|---|---|---|
| Communication | |||
| Significance of the staff’s non-verbal and verbal body language | 1 | PT01 |
Yes, but I thought the whole thing was... Calm nurses and a pleasant doctor. No, I was completely calm about the whole thing. Well, a nurse came to get me, and she was really sweet. And what I like is that they surround you with calmness. |
| 2 | PT01 | The doctor was also very nice, and whistled during the surgery. I have never experienced that before. He has done this a million times, so he knows what he is doing. | |
| 3 | PT01 | And that means a lot as a patient and they give us a sense of calmness, and you are not afraid of it. | |
| 4 | PT04 | It went well and they were nice and friendly. | |
| 5 | PT05 | It was just calm and relaxed, I think. | |
| 6 | PT06 | It was very quiet... but the nurse said they don’t say much... and they really concentrate... I don’t know... I don’t know how you feel, but when I’m at the dentist, for example, I like it when they say something along the way so you have some sense of where we are. The only thing he said... was... ‘now I’m putting in the new lens...’ on the first eye... and then the nurse said... she said now we’re taking off the covering and getting ready for the next eye... the preparation takes the longest time... but then you just lie there and relax... | |
| 7 | PT11 | It was very nice. They spoke kindly. Very reassuring. It was the way the nurse talked to me. It was quite nice. | |
| 8 | PT07 | I think it was quiet and peaceful. | |
| 9 | PT09 | It was a pleasant experience and they told us what they were doing. | |
| 10 | PT13 | I think it was the empathy and atmosphere there. And just like that, it was me. It’s time to get started. | |
| 11 | PT13 |
In the operating room... I thought it was nice... The doctor had said, ‘now I’m starting my machine which might make some noise,’ and then I started following along in my mind. I was fine with that... |
|
| 12 | PT14 |
It was so nice. They sat and chatted a bit while he operated. It was somewhat cozy. I could lie down and listen to what they were talking about. About the whole world situation. Yes, there was such a calmness over everything. But incredibly friendly, sweet staff. Well, I have to say that. Sweet and humorous staff. |
|
| 13 | PT15 | You inform and so on... so there is nothing to complain about. | |
| 14 | PT16 | I felt prepared, and I was told along the way what I had to do and expect. For example, when they had to clean the cataract, they prepared me for the sounds, and I was very happy about that. Otherwise, I might well have been a bit surprised and would have thought ‘what the heck is that’. But I was prepared for it. | |
| 15 | PT17 | I do suffer a bit from anxiety. And I didn’t felt that at all. I was safe in hands. I am absolutely sure of that. It was the way the doctor spoke and the nurses helped me, etc. | |
| 16 | PT17 | Otherwise quiet and calm and pleasant voice. Some explanations in between and then I could hear that they were talking professionally behind the scenes. And I felt completely comfortablewith that. | |
| 17 | PT18 | It happened very calmly. The communication between the surgeon and the nurse, and I can’t remember who assisted... The only thing that was a little uncomfortablewas that ultrasound scanner. | |
| 18 | PT20 | I felt like I was constantly informed about what was going to happen... and in the operating room... it’s nothing to talk about... it all happened very calmly. | |
| Calm and safe atmosphere | 19 | PT08 | I felt safe and not afraid at all. |
| 20 | PT12 | Well, so I felt I was in safe hands. | |
| 21 | PT13 | I think there was a pleasant atmosphere in the waiting room. There were some nice and pleasant nurses. | |
| Importance of oral and written information | 22 | PT01 |
Well, I was in the presence of a nurse who just had to check up on my eyes and so on. Then I went on to see a doctor, who I think explained very clearly how things were going to proceed. I think I was well informed. |
| 23 | PT03 | I think I was well-prepared. I had read about it and felt well-prepared for what it entailed and what I would go through. So in that way, I wasn’t nervous; it’s more about the fact that it’s the eyes. | |
| 24 | PT05 | Yes, I think so. But I had misunderstood it. I thought I was supposed to use eye drops three days before the surgery. | |
| 25 | PT07 | Yes, I think so. I was prepared for what the sounds would be like... That’s fine. And the video on the IPad, it was also nice to hear. | |
| 26 | PT08 | And I would say they took their time and there was a lot of attention to whether it was understood. I think I got it described well by the young doctor for the preliminary examination. He was very clear about it. | |
| 27 | PT11 | I got a piece of paper to take home so I was prepared based on that. It wasn’t a problem, I think... and then I was a little nervous about it because I have some claustrophobia. About how much I was covered. But it was nothing to talk about. | |
| 28 | PT12 | They told me how it was going to proceed. It was really nice. | |
| 29 | PT13 | I think I have been through a good examination at your outpatient clinic. Both with an optician and a conversation with a doctor. I think it had a nice common thread. Yes, I think I was well-informed. | |
| 30 | PT20 | First of all, I received really good information. Both orally and in writing. How I should behave and such things. And they also explained each time I was moved to a new machine and what it did. ‘Now you get blown in the eye and now this happens’. So that was really reassuring | |
| The experience of the surgery | |||
| The tense and nervous patient | 31 | PT01 | Of course, I was nervous about how it would be afterwards. |
| 32 | PT03 | Of course, I was tense. And then there is the fact that when you undergo surgery, the first thing you usually do is to close your eyes, and obviously I couldn’t really do that in this case. | |
| 33 | PT05 | Of course, I was nervous to see how it would go. | |
| 34 | PT12 | Of course you are a little tense. | |
| 35 | PT13 | I was a bit tense. | |
| 36 | PT16 | You are probably always tense and nervous. Not beyond ordinary. | |
| The feeling of the 1steye versus the 2ndeye. | 37 | PT07 | The same... Yes, I think so. I couldn’t tell any difference to it. |
| 38 | PT09 | Yes, and it was the same sounds. Everything was the same. | |
| 39 | PT12 | No, it was straight from one to the other. So right at the start it was very blurry because of the liquid and water. However, it went quickly. From the right eye to the left eye. It did not take more than half an hour. And yes, my vision is fantastic now. | |
| 40 | PT12 | No, no difference at all. I did not think about that at all. It has been the same. | |
| 41 | PT16 | It was actually the same, I think. | |
| The time after the surgery | |||
| Vision gain/Visually impaired | 42 | PT01 | I haven’t experienced any improvement after the surgery... But I do have that tear in my retina that needs to be fixed first before my vision can be assessed. |
| 43 | PT02 | Yes, yes. It is sharper. And when I read and put on glasses, it is more black and clear. I used to see double, I do not do that anymore. It is much better. | |
| 44 | PT05 | It has gotten a lot better now. It cannot be any better. | |
| 45 | PT07 | I think when I’m looking around… I think it is fantastic. I think it was good and now I can see much better than I could see before. | |
| 46 | PT09 | And after the surgery it was just perfect. | |
| 47 | PT11 | No problem and it worked 100% It is perfect. | |
| 48 | PT12 | I could see the next day like a newborn. | |
| 49 | PT12 | However, the result. I think it is fantastic. | |
| 50 | PT14 | It was like that I could not read anymore at the end. And now I can read my morning paper again. | |
| 51 | PT15 | At least it is a fantastic result. It is only now that you experience how bad it really was. It is absolutely fantastic to be able to watch television with subtitles. Now it is clear. | |
| The patient’s experience | 52 | PT05 | No, I can say that they can quite easily say yes. |
| 53 | PT09 | Do it. There can be no negatives whatsoever. | |
| 54 | PT12 | All I can say is take it easy and relax. You are in good hands with them. You don’t have to go and feel bad and have a upset stomach. It goes so smoothly. Just relax... adjust to it... and then... and then remember it gets better... They are so experienced. | |
| 55 | PT13 | Then I can fully recommend it. I think there are terrific. | |
| 56 | PT15 | Get it done. It makes such a difference. There is such a huge difference. You do not notice how bad it has become because it goes so slowly. It just makes a huge difference. The discomfort is totally worth it. | |
| 57 | PT17 | Listen carefully to what is said and prior that, read the papers. It is so well written. What you are going to do, and for how long. | |
| 58 | PT18 | Well, what you can do is remember to ask. And keep asking until you understand it. I have often experienced that from many people. That they do not ask. Then I think that if you have a little anxiety. Then that anxiety can become bigger. I do not think you should be afraid to ask. I think that’s the most important thing. That is what gives security. The thing about going to an operating theatre. Do not be afraid of the staff around you. They have to be dressed in what they are dressed in. That’s the way it is. But that might scare someone. | |
| Surgery completed/over | 59 | PT01 | No, I think it was nice that it was over within the same day. |
| 60 | PT02 | I would rather have both eyes operated at once than one eye at a time. It was not that bad, the surgery itself. | |
| 61 | PT03 | Yes, do it! Just do it. Then you get over it all at once, instead of having to go through it twice. Also because the waiting time is hard before you can have surgery. | |
| 62 | PT04 | I would say that if you are offered both eyes same day, you should do it. | |
| 63 | PT06 | I think it was kind of nice. I think so… to get it over with. | |
| 64 | PT06 | I just want to say that it is wonderful to get it over with. | |
| 65 | PT07 | Also because then I would have to go twice. Then maybe there are more people who can get it done instead of having such long waiting times. I am happy that I had the surgery now and everything has gone well. What I think is nice is that I can have both eyes done on the same day. I think many people benefit from that. | |
| 66 | PT08 | We talked about it back and forth but I was happy that he only had to go in there once. | |
| 67 | PT12 |
I only see that as an advantage. Then it is over. Yes. Yes, it has gone well. And get it over with, instead of having to go in again and order transport. |
|
| 68 | PT14 | Then it was nice to have both eyes fixed at once. Then you don’t have to go in there again and again. | |
| 69 | PT15 | Get it over with at once. Now I have also been waiting for a year. Because I have been canceled several times due to illness and lack of staff or something. So now I just wanted to get it over with. | |
| 70 | PT16 | So I think when you lie in it, just get it done. Then it’s over. So I think it’s a good thing to take both eyes at once. So it’s over. Get over it when you’re in it. | |
| 71 | PT19 | Getting it done in one go means you don’t have to leave again. | |
| 72 | PT20 | It was just to get it over with. | |
PT: Participant
Communication
Under this main theme, three subthemes emerged: The significance of the staff ’s verbal and non-verbal communication, the calm and safe environment and the significance of both oral and written information.
One of the most significant factors for the participants is the verbal and non-verbal communication from the staff. The participants mentioned how forthcoming, calm and nice the staff were at all times, including both the appointment for the pre-operative cataract assessment and later on the day for the actual surgery. The participants felt spoken to in a good and inclusive manner, both when they were received and during examinations and surgery (Q1–4, 7–16, 18). They mention that this applies to both ophthalmologists and nurses, describing them as very empathetic and skilled at creating an environment that makes each patient feel centred (Q10). The participants also describe that the staff appeared relaxed and calm in their body language and that there was whistling or small talk during the surgery (Q2, 12, 17). This gives the participants a feeling that the situation is completely under control.
The staff also created a calm and secure atmosphere in the waiting area (Q3, 21), which overall supports the sense of security the participants need in such situations. Participants mention that eye surgery can seem frightening, yet a calm and secure atmosphere is very important, so they can get through the surgery in local anaesthesia as smoothly as possible (Q11, 19–21).
Furthermore, the participants talk about the importance of both verbal and written information regarding the procedure (Q22–30). First and foremost, they point out that ample time is allocated for the preliminary examination, providing a good opportunity to cover all aspects and ask questions (Q30). They report that the staff is very attentive to ensuring that the participants correctly understand the information. In addition, it is important that the information is communicated in an understandable language (Q26), and one participant mentioned that the informational video shown on the iPad was useful (Q25). Overall, the participants felt very well-prepared for both the verbal and written information, and they experienced a consistent flow throughout the preliminary examination (Q29). The thorough information makes the participants feel secure about what is going to happen, as they are reassured by having everything explained to them in advance in a calm setting (Q23).
The experience of the surgery
Under this main theme, two subthemes emerged: The tense and nervous participant and the experience with the 1st eye versus the 2nd eye.
Several participants described a form of nervousness or tension related to having both eyes operated on the same day (Q31–36). They were concerned about the outcome of the surgery but also felt a bit uneasy since it involved operating on their eyes (Q32). When undergoing surgery, it is natural to close the eyes but that is not an option here (Q32). The participants felt that a lot is at stake when it involves eye surgery (Q23). However, they also mention that when the staff are good at explaining things during the surgery, it greatly alleviates their nervousness. They particularly highlight the importance of information about sounds and machines but also note that casual small talk from the nurse, for example, can be calming (Q7, 9, 11–15). One participant experienced that there was a lot of silence in the operating room and explained that he was missing information about what was happening around him and how far along the surgery was Q5–6.
The participants describe their experience with the surgery on the first eye as so pleasant that they were eager to proceed with the second eye immediately, even though they were given the option to discontinue the surgery and have the second eye operated on at a later time. They report that the experience with the second eye was the same and that the surgery was painless and quickly completed (Q37–41).
The post-operative period
Under this main theme, three subthemes emerged: vision improvement, participant experiences and the completed surgery. Most participants quickly felt that the surgery had a positive effect on their vision (Q43–51). One participant had other underlying conditions that negatively affected their vision and thus did not experience the same benefits from the surgery; however, they still described the surgery as a good and positive experience, knowing beforehand that replacing their lens would not necessarily improve their vision (Q42).
Several patients would recommend others to accept treatment for both eyes on the same day, highlighting their satisfaction with the procedure (Q52–56, 60–62). In addition, the participants mentioned that it is important to listen carefully to the information provided both before and during the surgery and to read the written material they receive (Q57). One participant indicated feeling well prepared but also mentioned having misunderstood the information about whether to use eye drops before or after the surgery (Q24). Furthermore, a participant emphasised the importance of asking about anything they are uncertain or nervous about and continuing to ask until they get an answer they understand, as this helps provide reassurance (Q58). Another common sentiment amongst the participants was their relief that the surgery was completed. They specifically emphasised that not having to return to the hospital for a second appointment was a highly positive aspect (Q59–72).
DISCUSSION
This study evaluated participants’ perspectives and experiences with same-day bilateral cataract surgery. Three main themes emerged from the analysis: Communication, the surgical experience and the post-operative period. The study highlighted that the importance of communication, specifically the non-verbal communication of the staff, helps create the calm and reassuring atmosphere that participants experienced during their surgery. Furthermore, the participants in this study also emphasised the importance of written information, noting that thorough written materials provided them with greater confidence before the surgery. In the study by Campbell et al.,[17] an increased need for more comprehensive written information was identified. It was also suggested that addressing the most common questions about the surgery within the written materials could further support patients’ acceptance of same-day bilateral cataract surgery. In this study, the combination of written and verbal information is shown to make the participants feel calmer and better prepared for the surgery.
It should be noted that this study primarily included patients receiving standard monofocal intraocular lenses. Thus, the findings may not be generalisable to patients receiving premium lenses, such as extended depth of focus or multifocal lenses, where refractive planning between eyes may require staged procedures.
In the study by Malcolm et al.,[8] patients were asked about their choice to have cataract surgery on both eyes on the same day. The second most common reason for choosing this approach, instead of having surgery on two separate days, was to avoid experiencing the anxiety and stress of going to the hospital twice. In this study, participants did not express anxiety or fear directly but instead used softer terms, such as feeling tense, which they regarded as typical when undergoing surgery. Communication strategies to help maintain low stress and anxiety levels during the procedure are likely to be important for hospital staff.
With this type of surgery, it is difficult to compare the outcomes of same-day bilateral cataract surgery with the traditional method of operating on each eye separately, as participants can only reflect on their own experience and are not able to undergo both approaches. While it remains unclear which method is most preferable for the patients due to experience, the study by Carolan et al.[9] suggests that having both eyes operated on the same day does not lead to an inferior experience compared to surgeries performed on different days.
Our study highlights positive experiences with same-day bilateral cataract surgery, which is a relatively new approach in Denmark. A study conducted in England yielded results similar to ours[17] yet, their follow-up was conducted 4 weeks post-surgery, whereas our interviews took place closer to the time of the operation. This allowed us to assess patients’ perspectives and emotions about the procedure closer to the time it occurred, with fewer details and feelings forgotten over time. In future research, it could be valuable to interview patients directly after the surgery to gain insights into their immediate experiences. However, this approach presents logistical challenges, particularly given the vulnerable state of patients shortly after undergoing bilateral eye surgery.
One of the key aspects emphasised by the participants when reflecting back on the surgery during the post-operative period was their relief that the procedure was completed. They particularly appreciated that it was done in one session, eliminating the need for multiple hospital visits. This sentiment aligns with findings from other studies, where patients also expressed satisfaction with completing the procedure in a single session. This approach reduces their reliance on repeated assistance and minimises the need to take extended leave from work.[8,17] In addition, participants expressed that they would encourage future patients to proceed without hesitation and not feel anxious, as having the procedure done on the same day was seen as highly beneficial. This suggests a high level of patient contentment with the approach.
Since it is also a health-economic benefit to operate on both eyes on the same day, it supports the idea that it is a beneficial approach for all concerned to continue the implementation.[23] The increasing number of patients who need cataract surgery called for innovative solutions to meet the patients’ needs.[17,23] It has been challenging to change the approach to same-day bilateral cataract surgery due to concerns about complications and an expectation that patients did not want this type of surgery, which has so far hindered further implementation of this approach.[24-26]
A key strength of this study is the specialist team’s role in reviewing themes and developing the questionnaire to ensure broad clinical relevance. Semi-structured telephone interviews provided flexibility, reducing social desirability bias and minimising patient burden by eliminating the need for computer skills or hospital visits. In addition, interviewing patients treated by different surgical teams offered a broader perspective.
Key limitations include the inability to read body language in telephone interviews, potential selection bias as complex cases are excluded from same-day surgery and recall bias due to post-operative-only interviews. To mitigate this, the interview-surgery interval was limited to 7–9 days. Using two interviewers may introduce variability but also enhance perspective diversity.
CONCLUSION
Same-day bilateral cataract surgery is well-received by patients, who express satisfaction and even a willingness to recommend the approach to future patients. Empathetic communication before, during, and after the surgery is important for contributing to the positive reception of this surgical approach.
Insights from this study, along with research on health-economic benefits and favorable complication rates, may pave the way for the wider implementation of same-day cataract surgery, helping to address future resource challenges in the healthcare system.
Acknowledgements:
The facilities utilised by the project have been provided through OPEN, the Open Patient Data Explorative Network. The project has benefited from facilities such as OPEN IT and data management. Specifically, the project utilised the IT facilities OPEN Analysis and OPEN Qualitative, which included the use of NVivo for qualitative data analysis and audio files from interviews.
Authors’ contributions:
TTL and CW contributed equally as first authors. BST contributed with expert advice during the drafting of the manuscript.
Ethical approval:
The research/study was approved by the Institutional Review Board in the Region of Southern Denmark (Record no. 24/7162). No further ethical approval was required according to Danish national regulations.
Declaration of patient consent:
The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil.
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