A total of 302 participants were enrolled in this study. One hundred and fifty-six (51.7%) were male and one hundred and forty-six (41.3%) were female, with a mean age of 30.48±8.44 (18 to 57) years.
Willingness to accept keratorefractive surgeries
After the educational session on keratorefractive surgery have been done, the varying responses of the participants with respect to their willingness to accept keratorefractive surgeries are as shown in Figure 1.
Reasons for accepting to do keratorefractive surgery
Out of the 63 participants who were willing to undergo keratorefractive surgeries, 87.3% were tired of using spectacles/contacts while 11.1%, reported as career reasons, shown in Table 1.
Table 1: Reasons for accepting to do keratorefractive surgery
Reasons for accepting
|
Frequency*
N=63
|
Percentage (%)
|
Tired of using spectacles/contacts
|
55
|
87.3
|
Career reasons
|
7
|
11.1
|
Do not want to use spectacles
/contacts
|
4
|
6.3
|
Beautification
|
4
|
6.3
|
leisure
|
1
|
1.6
|
No reason
|
1
|
1.6
|
* Some participants gave multiple responses
Barriers to uptake of Keratorefractive Surgery
Out of the 137 participants who were unwilling to undergo keratorefractive surgeries, 59.1% reported fear of surgery as their reason while 41.6%, reported as lack of awareness, shown in Table 2.
Table 2: Barriers to uptake of keratorefractive Surgery
Barriers
|
Frequency*
N=137
|
Percentage (%)
|
Fear of surgery
|
81
|
59.1
|
Lack of awareness
|
57
|
41.6
|
Financial constraints
|
56
|
40.9
|
Adverse effects
|
27
|
19.7
|
Satisfied with vision
|
9
|
6.6
|
Negative advice
|
3
|
2.2
|
No reason
|
3
|
2.2
|
* Some participants gave multiple responses
Reasons for not being sure of accepting keratorefractive surgery
One hundred and two (34%) participants were not sure if they would have keratorefractive surgery or not. Reasons are shown in Table 3.
Table 3: Reasons for not being sure of accepting keratorefractive surgery
|
Frequency*
N=102
|
Percentage (%)
|
Reasons for possible acceptance
Tired of using spectacles/contacts
|
60
|
58.8
|
Do not want to use spectacles
/contacts
|
28
|
27.4
|
Beautification
|
8
|
7.8
|
Career reason
|
2
|
2.0
|
No reason
|
9
|
8.8
|
Reasons for possible non-acceptance
Financial constraint
Fear of surgery
Lack of awareness
Adverse effects
Satisfied with vision
Negative advice
No reason
|
62
51
36
20
1
2
3
|
60.8
50
35.5
19.6
1.7
3.3
5.0
|
* Some participants gave multiple responses
Willingness to accept keratorefractive surgery with associated variables
The results in table 4 showed the associations between willingness to accept keratorefractive surgeries and socio-demographic variables/degree of myopia. Degree of myopia showed significant association with willingness to accept keratorefractive surgery (chi-square p<0.001). However, there were no significant association between age, gender, place of residence, level of education, income, occupation and willingness to accept keratorefractive surgery.
Table 4 : Test of association between degree of myopia/demographic characteristics and willingness to accept keratorefractive surgery
Variable
|
willingness to accept keratorefractive surgery
|
|
Yes
|
No
|
Maybe
|
p-value
|
Age(years)
<40
≥40
|
57 (22.3)
6 (13.0)
|
114 (44.5)
23 (50.0)
|
85 (33.2)
17 (37.0)
|
0.366
|
Gender
Male
Female
|
36 (23.1)
27 (18.5)
|
65 (39.7)
72 (49.3)
|
55 (35.2)
47 (32.2)
|
0.379
|
Place of residence
Rural
Urban
|
8 (11.1)
55 (24.0)
|
38 (52.8)
99 (43.0)
|
26 (36.1)
76 (33.0)
|
0.061
|
Level of education
<Tertiary education
≥Tertiary education
|
7 (18.9)
56 (21.1)
|
16 (43.3)
121 (45.7)
|
14 (37.8)
88 (33.2)
|
0.850
|
Occupation
Unemployed
Employed
|
21 (19.3)
42 (21.7)
|
55 (50.5)
82 (42.5)
|
33 (30.2)
69 (35.8)
|
0.406
|
Income (Annually/Naira)
<1,000,000
≥1,000,000
|
36 (20.1)
27 (22.0)
|
81 (45.3)
56 (45.5)
|
62 (34.6)
40 (32.5)
|
0.898
|
Degree of myopia
Low to moderate
High myopia
|
31 (11.9)
32 (76.2)
|
133 (51.2)
4 (9.5)
|
96 (36.9)
6 (14.3)
|
<0.001*
|
* Statistically significant
Focused group discussion/in-depth interview
Fifteen (15) participants were enrolled in the focus group while twenty-one (21) participants participated in the in-depth interview. Barriers to uptake of keratorefractive surgery and the motivation for uptake of keratorefractive surgery were the themes that emerged from the analysis.
Barriers to uptake for keratorefractive surgery
The dominant barriers to the uptake for keratorefractive surgery were fear of complications and financial constraints. Many participants believed that the lack of awareness on the safety of the procedure in Nigeria and also lack of trust in Nigerian doctors, contributed greatly to the ‘fear’ seen in individuals.
Participant from focus group : ‘hmm…. Can’t allow a doctor in Nigeria touch my eye without seeing evidence of his/her success stories with previous patients’
Participant from focus group : ‘my vision is good, I don’t need it’
Participant from in-depth interview : ‘haaaaa…...where can I get such amount of money for the surgery. It’s just for the financially privileged’
Motivation for uptake of keratorefractive surgery
Three forms of motivation towards the uptake of keratorefractive surgery were tired of using spectacles, beautification and career reasons.
Most of the participants were tired of using spectacles and would do anything to make them stop wearing spectacles. The females generally reported that they were not able to show their make ups with their spectacles on and would love to be able to make up and move around without their spectacles.
Participant from in-depth interview : ‘I work as a customer care representative in a bank, I never liked it that I couldn’t take out my spectacles and look like my other colleagues who do not wear spectacles. I felt they were more beautiful and smarter… now I have done the surgery, my self-worth is back. The first day at work, my colleagues couldn’t recognize me. They were amazed and said that I looked more beautiful’
Participants from focus group : ‘I have been using spectacles for 30 years and am tired. I really want to be free from it’