Patient-Reported Outcome Measures in Cataract Surgery

Abstract

This thesis investigates the implementation and applicability of Patient-Reported Outcome Measures (PROMs) in routine cataract surgery care in Australia, with a focus on improving patient-centred outcomes and aligning local practice with international standards. While PROMs are increasingly integrated into clinical workflows worldwide to guide decision-making and evaluate healthcare quality, their use in Australia remains largely confined to research and benchmarking. Through a systematic review and Rasch analysis, this work validates the psychometric robustness of the Catquest-9SF questionnaire and demonstrates its superiority over the Priquest in measuring vision-related quality of life following cataract surgery. The thesis highlights the limitations of existing PROMs in reflecting the outcomes of modern cataract procedures, such as those involving multifocal intraocular lenses and immediate sequential surgeries. It also presents a practical implementation protocol using a web-based platform to address barriers to routine PROMs uptake. The findings underscore the importance of tailoring PROMs to evolving surgical techniques and patient preferences, and advocate for their wider adoption in Australia to support better clinical practice, enhance shared decision-making, and improve surgical outcomes.