# Knowledge, attitudes, and practices of adult patients with myopia toward refractive surgery and postoperative medications: a cross-sectional study

## TL;DR

This study explores what myopia patients know and how they behave regarding refractive surgery and postoperative care, finding gaps in knowledge and practices.

## Contribution

The study identifies a significant relationship between knowledge, attitudes, and practices in myopia patients undergoing refractive surgery.

## Key findings

- Patients showed insufficient knowledge and suboptimal practices despite positive attitudes toward refractive surgery.
- Knowledge significantly influenced attitudes and practices, with attitudes also directly affecting practices.
- Education strategies are urgently needed to improve adherence and postoperative visual quality.

## Abstract

This study aims to assess the knowledge, attitudes, and practices (KAP) of adult patients with myopia regarding refractive surgery and the use of postoperative medications.

A cross-sectional survey was conducted between July 2024 and November 2024 at The Affiliated Hospital of Panzhihua University. Data were collected using a structured questionnaire.

A total of 433 valid responses were collected. Among the participants, 231 (53.3%) were female, 216 (49.9%) had a spherical equivalent refractive error between −3.00 and −6.00 diopters in both eyes, and 154 (35.6%) reported daily screen time ranging from 6 to 12 h. The mean (SD) knowledge, attitude, and practice scores were 10.60 (range: 0–18), 38.61 (range: 11–55), and 18.81 (range: 6–30), respectively, where the ranges indicate the minimum and maximum achievable scores. Significant positive correlations were found among knowledge, attitude and practice (p < 0.001). Multivariate analysis revealed that knowledge significantly influenced both attitude (OR = 1.200, 95% CI: [1.133,1.272], p < 0.001) and behavioral engagement (OR = 1.255, 95% CI: [1.177,1.339], p < 0.001). Structural equation modeling (SEM) results showed that knowledge directly affected attitude (β = 0.546, p < 0.001) and practice (β = 0.246, p < 0.001), attitude also directly affected practice (β = 0.468, p < 0.001). Additionally, knowledge indirectly affected practice through attitude (β = 0.256, p < 0.001).

Patients with myopia demonstrated insufficient knowledge and suboptimal practices despite generally positive attitudes toward refractive surgery and postoperative care. These findings highlight the urgent need for structured patient education strategies to improve adherence and optimize postoperative visual quality.