Informed consent for cataract surgery: What patients do and do not understand

Purpose: To determine patients' understanding and opinions about the usefulness of the informed consent (IC) document for cataract surgery and evaluate the deterioration in the effectiveness of verbal and written IC over time. Setting: Academic tertiary care center. Methods: Multiple-choice questionnaires addressing specific information about cataract surgery were distributed to patients. The questionnaires covered topics such as treatment, risk, and outcome probabilities (assessed preoperatively and postoperatively); terminology commonly used in IC; and patients' opinions about IC. Scores were calculated and compared using paired and unpaired t tests. Results: Twenty-six patients thought that their legal autonomy would be waived by signing a consent form. Patients who took part in a standardized discussion of IC before testing scored 73.4% versus 23.4% in a control group who received no IC counseling (P<.001). Patient recall of outcome probabilities significantly decreased between preoperative and postoperative testing (61.2% to 44.0%) when IC was given verbally but improved to 75.0% when patients were given written information to take home. Conclusions: Patients about to consent to cataract surgery had a reasonable grasp of basic terminology. A standardized IC discussion was effective in educating patients. Patients considered IC to be important and expected all pertinent information to be communicated. Patient recall of outcome probabilities was poorer than that of nonnumeric facts; however, memory decay may be slowed by providing supporting take-home literature. (C) 2003 ASCRS and ESCRS