What is it about?

Deciding to undergo macular hole surgery requires a certain commitment on the part of the patient as a post-surgical face-down positioning is often required, which is difficult and uncomfortable, especially for older adults. Therefore, it is not surprising that some patients will chose not to undergo the treatment. We decided to compare a group of individuals who declined surgery with a group who chose the treatment. The groups did not differ on clinical variables, indicating that personal preferences and internal variables are likely better predictors.

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Why is it important?

Macular hole surgery is one of the types of treatment, similarly to vision rehabilitation, where the outcome success in part depends on the participation and adherence of the patient to the post-treatment regimen. Given this level of control makes it very important for the patient to understand their contribution to the outcome.


As a student at the time of this study, I found it fascinating that some patients would decline a treatment that has been shown to be effective. It was the first time for me to be face to face with a medical treatment choice that I did not understand. Having more experience now, I realize that this study was the beginning for me to understand the complexity of patient decision-making.

Dr Walter Wittich
Universite de Montreal

Read the Original

This page is a summary of: Vision Impairment by Choice: Why Do Patients Decline Macular Hole Surgery?, Visual Impairment Research, January 2006, Taylor & Francis,
DOI: 10.1080/13882350601096345.
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