IMPACT OF INTRAOCULAR LENS DESIGN ON VISUALQUALITY AND PATIENT SATISFACTION AFTER CATARACT SURGERY
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Keywords
Cataract surgery; Intraocular lens design; Visual quality; Patient satisfaction; Spectacleindependence
Abstract
Cataract surgery had evolved into a refractive procedure aimed at improving patient satisfaction andpostoperative visual quality. Advances in intraocular lens (IOL) design had expanded visualoutcomes beyond distance vision to include intermediate and near vision, while also influencingvisual disturbances and spectacle dependence. This study aimed to compare the impact of differentIOL designs on postoperative visual quality and patient satisfaction following cataract surgery. Thisretrospective observational study included 120 patients who underwent uncomplicated cataractsurgery with implantation of a single type of IOL. Patients were equally assigned to four groups:monofocal, enhanced monofocal, multifocal/trifocal, and extended depth-of-focus (EDOF) lenses.Postoperative outcomes included visual acuity, visual disturbances, patient satisfaction, andspectacle dependence. Statistical analysis involved descriptive statistics, chi-square tests, correlationanalysis, and multivariate regression. Postoperative distance visual acuity was favorable across allIOL groups. Enhanced monofocal, multifocal/trifocal, and EDOF lenses demonstrated superiorintermediate visual acuity compared with standard monofocal lenses, while multifocal/trifocallenses achieved the best near visual acuity. Visual disturbances were more frequent in themultifocal/trifocal group, whereas monofocal and enhanced monofocal lenses showed fewerdysphotopsia symptoms. Patient satisfaction was high across all groups, with significantly higherspectacle independence observed in the multifocal/trifocal and EDOF groups. Intraocular lens typeand spectacle independence were significant predictors of patient satisfaction. Overall, intraocularlens design played a key role in postoperative visual quality and functional outcomes, highlightingthe importance of individualized IOL selection to optimize satisfaction after cataract surgery.
References
surgery: A pragmatic study. Clinical Epidemiology and Global Health. 2019 Sep 1;7(3):509-12.2.Wang SY, Stem MS, Oren G, Shtein R, Lichter PR.Patient-centred and visual quality outcomes
of premium cataract surgery: a systematic review. European Journal of Ophthalmology. 2017Jun 26;27(4):387-401.
3.Ison M, Scott J, Apel J, Apel A. Patient expectation, satisfaction and clinical outcomes with a
new multifocal intraocular lens. Clinical Ophthalmology. 2021 Oct 13:4131-40.
4.Rementería-Capelo LA, Contreras I, García-Pérez JL, Blázquez V, Ruiz-Alcocer J. Visual
quality and patient satisfaction with a trifocal intraocular lens and its new toric version. Journalof Cataract and Refractive Surgery. 2019 Nov 1;45(11):1584-90.
5.Fernández J, Alfonso Sánchez JF, Nieradzik M, Valcárcel B, Burguera N, Kapp A. Visual
performance, safety and patient satisfaction after bilateral implantation of a trifocal intraocularlens in presbyopic patients without cataract. BMC ophthalmology. 2022 Aug 10;22(1):341.
6.Pedrotti E, Mastropasqua R, Bonetto J, Demasi C, Aiello F, Nucci C, Mariotti C, Marchini G.
Quality of vision, patient satisfaction and long-term visual function after bilateral implantationof a low addition multifocal intraocular lens. International Ophthalmology. 2018Aug;38(4):1709-16.
7.Carolan JA, Amsden LB, Lin A, Shorstein N, Herrinton LJ, Liu L, Carnahan M. Patient
experience and satisfaction with immediate sequential and delayed sequential bilateral cataractsurgery. American Journal of Ophthalmology. 2022 Mar 1;235:241-8.
8.Hammond MD, Potvin R. Visual outcomes, visual quality and patient satisfaction: comparing a
blended bifocal approach to bilateral extended depth of focus intraocular lens implantation.Clinical Ophthalmology. 2019 Nov 27:2325-32.
9.Jain S, Rajshekar K, Aggarwal A, Chauhan A, Gauba VK. Effects of cataract surgery and intra-
ocular lens implantation on visual function and quality of life in age-related cataract patients: asystematic review protocol. Systematic reviews. 2019 Aug 13;8(1):204.
10.Ganesh S, Brar S, Pawar A. Long-term visual outcomes and patient satisfaction following
bilateral implantation of trifocal intraocular lenses. Clinical Ophthalmology. 2017 Aug 9:1453-9.
11.Stolk‐Vos AC, Visser MS, Klijn S, Timman R, Lansink P, Nuijts R, Tjia K, Zijlmans B,
Kranenburg LW, Busschbach JV, Reus NJ. Effects of clinical parameters on patient‐reportedoutcome in cataract patients: a multicentre study. Acta Ophthalmologica. 2018 Sep;96(6):586-91.
12.Mencucci R, Cennamo M, Venturi D, Vignapiano R, Favuzza E. Visual outcome, optical
quality, and patient satisfaction with a new monofocal IOL, enhanced for intermediate vision:preliminary results. Journal of Cataract and Refractive Surgery. 2020 Mar 1;46(3):378-87.
13.Oliveira RF, Vargas V, Plaza-Puche AB, Alió JL. Long-term results of a diffractive trifocal
intraocular lens: visual, aberrometric and patient satisfaction results. European Journal ofOphthalmology. 2020 Jan;30(1):201-8.
14.Yeu E, Cuozzo S. Matching the patient to the intraocular lens: preoperative considerations to
optimize surgical outcomes. Ophthalmology. 2021 Nov 1;128(11):e132-41.
15.Galvis V, Escaf LC, Escaf LJ, Tello A, Rodríguez LD, Lapid-Gortzak R, Carreño NI, Berrospi
RD, Niño CA, Viberg A, Camacho PA. Visual and satisfaction results with implantation of thetrifocal Panoptix® intraocular lens in cataract surgery. Journal of Optometry. 2022 Jul1;15(3):219-27.
16.Rodov L, Reitblat O, Levy A, Assia EI, Kleinmann G. Visual outcomes and patient satisfaction
for trifocal, extended depth of focus and monofocal intraocular lenses. Journal of RefractiveSurgery. 2019 Jul 1;35(7):434-40.
17.Paik DW, Park JS, Yang CM, Lim DH, Chung TY. Comparing the visual outcome, visual
quality, and satisfaction among three types of multi-focal intraocular lenses. Scientific Reports.2020 Sep 9;10(1):14832.
18.Ribeiro FJ, Ferreira TB, Silva D, Matos AC, Gaspar S. Visual outcomes and patient satisfaction
after implantation of a presbyopia-correcting intraocular lens that combines extended depth-of-focus and multifocal profiles. Journal of Cataract and Refractive Surgery. 2021 Nov1;47(11):1448-53.
19.Damgaard IB, Ang M, Farook M, Htoon HM, Mehta JS. Intraoperative patient experience and
postoperative visual quality after SMILE and LASIK in a randomized, paired-eye, controlledstudy. Journal of refractive surgery. 2018 Feb 1;34(2):92-9.
20.Rementería-Capelo LA, García-Pérez JL, Gros-Otero J, Carrillo V, Pérez-Lanzac J, Contreras I.
Real-world evaluation of visual results and patient satisfaction for extended range of focusintraocular lenses compared to trifocal lenses. International Ophthalmology. 2021Jan;41(1):163-72.
21.Blancafort Alias S, Del Campo Carrasco Z, Salvador-Miras I, Luna Mariné S, Gómez Prieto
MJ, Liñán Martín F, Salvà Casanovas A. Exploring vision-related quality of life: a qualitativestudy comparing patients’ experience of cataract surgery with a standard monofocal IOL and anenhanced monofocal IOL. Clinical Ophthalmology. 2022 May 27:1641-52.
22.Hovanesian JA. Patient-reported outcomes of multifocal and accommodating intraocular
lenses: analysis of 117 patients 2–10 years after surgery. Clinical Ophthalmology. 2018 Nov12:2297-304.
23.Lambert SR, Cotsonis G, DuBois L, Nizam A, Kruger SJ, Hartmann EE, Weakley DR, Drews-
Botsch C, Infant Aphakia Treatment Study Group. Long-term effect of intraocular lens vscontact lens correction on visual acuity after cataract surgery during infancy: a randomizedclinical trial. JAMA ophthalmology. 2020 Apr 1;138(4):365-72.
24.Li S, Hu Y, Guo R, Shao Y, Zhao J, Zhang J, Wang J. The effects of different shapes of
capsulorrhexis on postoperative refractive outcomes and the effective position of the intraocularlens in cataract surgery. BMC ophthalmology. 2019 Feb 21;19(1):59.
25.Lapp T, Wacker K, Heinz C, Maier P, Eberwein P, Reinhard T. Cataract surgery—indications,
techniques, and intraocular lens selection. Deutsches Ärzteblatt International. 2023 May31;120(21-22):377.
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Dr Chidire Sathish Kumar
Assistant professor,Maheshwara medical College,[email protected]
Dr suman Choudhary
Assistant professor,Maheshwara medical College, [email protected]
Dr Manchirevula Sharanya
Post graduate,Maheshwara medical College,[email protected]
