Informed consent in senile cataract extraction

Abstract

One day after surgery for senile cataract, we interviewed 50 patients to determine what percentage of the preoperative informed consent was retained. No patient felt less inclined to undergo surgery after hearing the informed consent and all patients believed the preoperative explanation had been adequate. This study found retention of relevant information was only 37% when assessed by ten standard questions. Only two (4%) of the patients remembered more than two of the five risks of surgery. Blindness, the most frequently recalled, was known by only 17 (34%). More than 80% failed to recall either hemorrhage (46/50), infection (47/50), failure of the procedure to improve visual acuity (42/50), or death (44/50) as other complications. Only 20% (10/50) would have remembered to protect the operated-on eye. Patients denied prior counseling for four of the ten questions (mean). Factors related to poor retention include advanced age and less than a high school education. Previous cataract surgery, level of anxiety prior to surgery, and the patient's sex did not appear to influence retention.