title: Should patients set the agenda for informed consent? A prospective survey of desire for information and discussion prior to routine cataract surgery.
abstract: OBJECTIVE
  To ascertain the level of information relating to specific risks desired by patients prior to cataract surgery.
  
  
  METHODS
  Dedicated cataract surgery pre-assessment clinics of 2 hospitals in South West Wales, UK.
  
  
  METHODS
  Consecutive patients (106) were recruited prospectively. Of these, 6 were formally excluded due to deafness or disorientation. Eligible patients (100) were asked a set of preliminary questions to determine their understanding of the nature of cataract, risk perception, and level of information felt necessary prior to giving consent. Those who desired further information were guided through a standardized questionnaire, which included an audio-visual presentation giving information relating to each potential surgical complication, allowing patients to rate them for relevance to their giving of informed consent.
  
  
  RESULTS
  Of the entire group of 100, 32 did not wish to know "anything at all" about risks and would prefer to leave decision making to their ophthalmologist; 22 were interested only in knowing their overall chance of visual improvement; and 46 welcomed a general discussion of possible complications, of whom 25 went on to enquire about specific complications. Of these 25, 18 wished to be informed of posterior capsular (PC) tearing, 17 of endophthalmitis, 16 each of dropped lens, retinal detachment and corneal clouding, and 15 of bleeding, sympathetic ophthalmia, and PC opacification.
  
  
  CONCLUSIONS
  Patients differ in their desire for information prior to cataract surgery, with one significant minority favoring little or no discussion of risk and another wishing detailed consideration of specific risks. A system of consent where patients have a choice as to the level of discussion undertaken may better suit patients' wishes than a doctor-specified agenda.
authors.affiliation: Singleton Hospital, Swansea, UK;
authors.forename: Lee Teak
authors.initials: LT
authors.lastname: Tan
authors.forename: Huw
authors.initials: H
authors.lastname: Jenkins
authors.forename: John
authors.initials: J
authors.lastname: Roberts-Harry
authors.forename: Michael
authors.initials: M
authors.lastname: Austin