This was a prospective analysis of long-term patient-reported outcomes and satisfaction of post-cataract surgery with an accommodating or multifocal bilateral IOL implantation. All eyes were implanted with the Crystalens (Bausch + Lomb, Bedminster, NJ, USA), the AcrySof IQ ReSTOR (Alcon, Ft Worth, TX, USA), or the Tecnis Multifocal 4.0D (AMO, Abbott Park, IL, USA) IOL, with the surgeon using the most recent iteration/model number available at the time of cataract surgery. Patients who had undergone uncomplicated cataract surgery at least 2 years prior were identified through a database search and considered for enrollment in the patient-reported outcomes survey. In an attempt to identify 50 patients who could be enrolled in each group (multifocal and accommodating lenses), we searched data on all cataract surgeries performed from June 2005 to July 2013.
At the time of cataract surgery, all patients had a potential visual acuity (VA) of 20/25 as ascertained by the cataract surgeon, with a refractive goal in the nondominant eye of -0.75 D for patients receiving the Crystalens and a refractive goal of plano/plano in the multifocal IOL patients. (“Potential VA” was defined as predicted best corrected VA, with or without spectacles.) Exclusion criterion was any patient who had developed visually significant non-IOL-related morbidities during the postoperative period. Patients who had undergone postoperative YAG laser capsulotomy or laser refractive enhancement procedures were not excluded from the study. For the purposes of this analysis, an examiner masked to the type of implant examined a table from a database query showing the recent findings (not including IOL type) and diagnoses of all patients who responded to the questionnaire. (SeeFigure S1 for the questionnaire.) If, at the time of the survey, the patient had severe dry eye, maculopathy, posterior capsule opacification, or previous refractive surgery, the patient was excluded from analysis. Neither astigmatism nor residual refractive error were exclusion factors, as the author believes either of those conditions may affect patient-reported satisfaction.
The survey was administered in a single-center private practice setting by a technician masked to the type of IOL implant. Initially 224 patients were identified who could participate in the study; of those, 117 patients met both the inclusion/exclusion criteria and responded to the questionnaire and, therefore, had analyzable data. Of those, 68 patients received accommodating IOLs and 49 patients received multifocal IOLs.
Aspire IRB (Santee, CA, USA) approved the study protocol, and all participating patients provided a written informed consent, consistent with the Declaration of Helsinki.
At the time of cataract surgery, all patients had a potential visual acuity (VA) of 20/25 as ascertained by the cataract surgeon, with a refractive goal in the nondominant eye of -0.75 D for patients receiving the Crystalens and a refractive goal of plano/plano in the multifocal IOL patients. (“Potential VA” was defined as predicted best corrected VA, with or without spectacles.) Exclusion criterion was any patient who had developed visually significant non-IOL-related morbidities during the postoperative period. Patients who had undergone postoperative YAG laser capsulotomy or laser refractive enhancement procedures were not excluded from the study. For the purposes of this analysis, an examiner masked to the type of implant examined a table from a database query showing the recent findings (not including IOL type) and diagnoses of all patients who responded to the questionnaire. (See
The survey was administered in a single-center private practice setting by a technician masked to the type of IOL implant. Initially 224 patients were identified who could participate in the study; of those, 117 patients met both the inclusion/exclusion criteria and responded to the questionnaire and, therefore, had analyzable data. Of those, 68 patients received accommodating IOLs and 49 patients received multifocal IOLs.
Aspire IRB (Santee, CA, USA) approved the study protocol, and all participating patients provided a written informed consent, consistent with the Declaration of Helsinki.
