Factors Influencing Patients Decision Making Between Refractive Surgeries

Abstract

Background: With the increasing availability of refractive surgical procedures such as LASIK and Implantable Collamer Lens (ICL), understanding the factors that influence patient decision-making has become essential for effective counselling and surgical planning. While advances in technology have ensured safety and visual outcomes, the relative contribution of clinical, economic, and psychosocial factors to patient choice remains unclear. Aim: To evaluate the factors influencing patient decision-making for refractive surgery and to compare determinants involved in the selection between LASIK and ICL procedures. Methods: A cross-sectional survey-based study was conducted among individuals seeking refractive surgery consultation. Demographic details, refractive status, sources of information, and perceived importance of various decision-making factors—including cost, safety, recovery time, discomfort, peer influence, and surgeon or clinic reputation—were collected. Data were entered in MS Excel 2019 and analysed using SPSS version 23.0. The Mann–Whitney U test was applied to identify statistically significant factors influencing surgical decision-making and procedure selection.

Results: The majority of participants were male, (n=66) with astigmatism being the most common refractive error (p value 1.000) Friends and family emerged as the primary source of information  not applicable followed by advertisements and ophthalmologists. Among all evaluated factors, surgeon and clinic reputation was the only variable showing a statistically significant association with the decision to undergo refractive surgery (p = 0.023). Cost, safety, recovery time, discomfort, and peer experience, although rated as important, did not independently influence the final decision. No significant demographic or clinical differences were observed between patients choosing LASIK and those opting for ICL, and both groups rated key factors similarly.

Conclusion: The study highlights that trust in surgeon and clinic reputation is the most critical determinant in refractive surgery decision-making. While cost, safety, and recovery expectations are universally valued, they do not independently drive surgical acceptance or procedure choice. Selection between LASIK and ICL is primarily guided by clinical evaluation and surgeon counselling rather than patient demographics or socioeconomic factors.