Patient reported outcome measures (PROMs) in cataract surgery: a systematic literature review protocol

Background Patient reported outcome measures (PROMs) are essential tools for capturing the quality of life and symptom burden from the patient’s perspective, particularly relevant in cataract surgery due to its subjective impact on vision. Cataract surgery, a highly cost-effective intervention, faces a growing demand for high-quality PROMs to measure diverse patient experiences and outcomes. Contemporary studies identify 14 domains of vision-related quality of life, such as convenience, visual symptoms, and driving, which traditional PROMs may inadequately address. Additionally, the changing cataract surgery landscape, driven by advancements in intraocular lenses (IOLs) and patient populations, necessitates a re-evaluation of PROMs for cataract patients. Methods A systematic review will examine literature on PROMs in cataract surgery, including consensus studies, instrument development, psychometric evaluations, and implementation studies. Studies will be sourced from databases including PubMed, MEDLINE, Embase, Epub, CINAHL, CENTRAL, CDSR and Northern Light. Inclusion criteria focus on adult lens removal surgery, excluding non-ophthalmic, paediatric, or non-cataract studies. Articles will be screened by multiple reviewers. PROMs will be mapped to the 14 identified domains and evaluated using the COSMIN framework for psychometric assessment. Implementation aspects, including clinical usage, digitisation, and barriers to adoption, will also be assessed. Discussion The review will address critical gaps in PROMs for cataract surgery, including domain coverage, psychometric quality, and implementation in clinical and academic settings. It will highlight the evolving needs of a diverse patient population, including refractive lens exchanges, and the impact of modern IOL technologies on PROMs. A well validated quality assessment of cataract PROMs will provide a strong platform to understand the established instruments. This comprehensive analysis will guide future research directions, including the development of new instruments or item banks, and inform best practices for PROM implementation, ensuring alignment with value-based healthcare principles. Systematic review registration PROSPERO CRD420251007771