Study Links Popular Eye Surgery to Higher Levels of Neuroticism in Patients

DENVER – Adults who choose a common laser eye surgery called SMILE to correct their vision tend to show higher levels of a personality trait known as neuroticism, according to new research from Hong Kong. The finding may help doctors better counsel patients and improve satisfaction after the procedure.

Researchers compared scores on a standard personality test called the Big Five Inventory. They found that patients who opted for SMILE surgery scored higher on traits linked to neuroticism than a control group of people who did not choose the surgery. The two groups did not show major differences in the other four personality categories measured: extraversion, agreeableness, conscientiousness, and openness.

The study included 100 SMILE patients and 75 people who were not interested in any type of vision-correcting surgery. All participants filled out the Big Five Inventory, a 44-question survey that measures five key personality traits. After some people dropped out, the final analysis included 78 SMILE patients and 74 people in the control group.

Tiffany Wu, MBBS, of the University of Hong Kong, presented the findings at the Association for Research in Vision and Ophthalmology meeting. She said more research with larger groups of patients is needed to better understand the personality traits of people who choose refractive surgery.

“Given the predominance of neuroticism in patients choosing SMILE, it is important to advise clinicians to have an effective doctor-patient communication regarding the expectations, risks, and complications of the procedure,” Wu said. She noted that previous studies have shown a person’s psychological state plays a big role in how satisfied they are after vision-correction surgery.

“Patients undergoing SMILE may be more difficult to satisfy if postoperative complications arise,” Wu added. “It is vital that clinicians provide realistic counseling and avoid over-promising or under-delivering to these patients.”

Wu said that adding a psychological assessment to the consultation process could help manage expectations, improve counseling, and lead to better overall results for patients.

Session co-moderator Yoshinori Oie, MD, PhD, of Osaka University in Japan, asked whether the study checked the mental health status of the participants. Wu replied that it did not. “I think you raise a very valid point, given that our study showed that neuroticism tended to occur more in SMILE patients,” she said. “I think assessing mental status would add value to the study.”

Oie also asked whether the age of the patients could have affected the results. Wu agreed that age might play a role. “I think younger patients possibly care more about aesthetics and want to go for SMILE or other types of corrective surgery so that they don’t need prescription glasses,” she said. She noted that there has not been a large study specifically looking at whether younger people in Hong Kong are more neurotic than other age groups, but called the question valid.

An audience member suggested that a control group made up of people of similar age who were not seeking surgery might have given a better comparison. Wu acknowledged that this was a fair point for future research.

The SMILE group was slightly older on average (31.0 years old compared to 26.3 years old in the control group) and more likely to work in the service or retail sector. Women made up the majority in both groups, and education levels were similar.

The neuroticism domain of the Big Five Inventory measures traits like anxiety, anger, hostility, depression, self-consciousness, impulsiveness, and vulnerability. The SMILE group scored significantly higher in this category than the control group.

For background, Wu noted that past studies have looked at personality traits in patients who choose LASIK, another common vision-correction surgery. One study from China found that LASIK patients scored higher on dominance and tension and lower on emotional stability compared to people not seeking surgery. Researchers interpreted this as LASIK patients being more assertive and suspicious. A study from Peru showed that LASIK patients were more likely to take risks and adapt easily to new situations.

“Both studies suggested that personality profiles of LASIK patients influenced their decision to pursue refractive error correction,” Wu said. She explained that because SMILE and laser-based procedures like LASIK have similar outcomes, her team wanted to see if personality traits also played a role in the decision to choose SMILE specifically.

To give more context, Wu and her colleagues compared their results with a global analysis of Big Five personality traits across 56 countries. That analysis showed that the general population of Hong Kong scored highest for neuroticism and lowest for conscientiousness compared to other countries.

Source: MedPage Today