Factors affecting the decision for refractive surgery in patients with high degrees of ametropia.

PURPOSE: To evaluate reasons referred patients do not have refractive surgery.

SETTING

University Eye Clinic, Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.

DESIGN

Cross-sectional study.

METHODS

The case records of patients referred for refractive surgery from January 2011 to December 2012 were examined for explanatory reasons. Data measured at the clinical preexamination of those who did and those who did not have refractive surgery were compared. A logistic regression model was used to assess the measured data's influence on the decision to have or not have refractive surgery.

RESULTS

Of the 2150 patients whose records were reviewed, 939 (43.7%) refrained from having refractive surgery. The most common reason was a change of mind (40.7%) followed by low central corneal thickness (CCT) (12.6%) and unstable refraction (10.8%). The 939 patients who refrained from surgery had significantly higher astigmatism and lower intraocular pressure, CCT, and corrected distance visual acuity than the patients who had surgery. The patients who changed their minds were not significantly different in any parameter from the patients who had refractive surgery. Using an outcome threshold of 0.5, the logistic regression model classified 63.04% of the patients correctly.

CONCLUSIONS

Reasons for refraining from refractive surgery were numerous, with a change of mind after the preexamination being the most common. Patients who changed their minds were very similar to those who had surgery, indicating that personal factors were important determinants.

FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.