Korean J Ophthalmol.  2016 Jun;30(3):180-191. 10.3341/kjo.2016.30.3.180.

Visual Outcomes, Patient Satisfaction and Spectacle Independence with a Trifocal Diffractive Intraocular Lens

• Kretz FT
• Choi CY
• Müller M
• Gerl M
• Gerl RH
• Auffarth G

• KMID: 2373973
• DOI: http://doi.org/10.3341/kjo.2016.30.3.180

Abstract

PURPOSE
To evaluate visual outcomes following implantation of a trifocal diffractive intraocular lens (IOL) and to analyze their correlation with patient satisfaction and ease of performing daily tasks.
METHODS
This was a prospective study enrolling 100 eyes of 50 patients undergoing cataract surgery with implantation of trifocal IOL AT LISA tri 839MP. Visual and refractive outcomes were evaluated during a 3-month follow-up. Postoperatively, a questionnaire was used to evaluate patient satisfaction with regard to surgical outcome, spectacle independence, perception of photic phenomena, and ease of performing some vision-related activities.
RESULTS
A total of 91%, 87%, and 79% of eyes achieved a monocular uncorrected distance, near, and intermediate visual acuity of 0.1 logarithm of the minimum angle of resolution or better, respectively. After the surgery, 96% of the patients could perform their daily activities without problems. The mean spectacle independence scores for reading, doing computer work, and for distance were 10.33 ± 12.47, 5.71 ± 11.90, and 3.92 ± 9.77, respectively (scale: 0 = no spectacles needed; 40 = spectacles always needed). No correlation was found between spectacle independence and visual outcome (-0.101 ≤ r ≤ 0.244, p ≥ 0.087). Mean scores (0 = no symptoms; 40 = strong symptoms) for glare at night, ghost images, and halos were 15.15 ± 12.02, 4.49 ± 7.92, and 13.34 ± 10.82, respectively. No correlation was found between photic phenomena and visual outcome (-0.199 ≤ r ≤ 0.209, p ≥ 0.150). A total of 80% of patients reported satisfaction with the surgery outcome, and 86% would recommend the surgery to friends and family.
CONCLUSIONS
Implantation of the AT LISA tri 839MP IOL after cataract surgery provides effective visual restoration associated with a minimal level of photic phenomena, a positive impact on the performance of vision-related daily activities, and a high level of postoperative patient satisfaction.

Keyword

Cataract; Presbyopia; Surveys and questionnaire

MeSH Terms

Cataract Extraction/*methods
Eyeglasses
Female
Follow-Up Studies
Humans
Lens Implantation, Intraocular/*methods
Male
Middle Aged
*Patient Satisfaction
*Phakic Intraocular Lenses
Prospective Studies
Prosthesis Design
Pseudophakia/*physiopathology
Refraction, Ocular/*physiology
Surveys and Questionnaires
*Visual Acuity

Figure

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  Fig. 1 Distribution of monocular and binocular postoperative uncorrected distant, intermediate, and near visual outcomes in the analyzed sample. UDVA = uncorrected distance visual acuity; UIVA = uncorrected intermediate visual acuity; UNVA = uncorrected near visual acuity.

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  Fig. 2 Scatterplot showing the relationship between postoperative binocular logarithm of the minimum angle of resolution (logMAR) uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA).

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  Fig. 3 Distribution of patient responses regarding difficulty performing the following activities (scale: 1 = yes, 2 = partly, 3 = no, and 4 = no assessable): reading the newspaper, reading a book, watching TV, driving a car during the day, driving a car at night, shopping, doing computer work, working in the house or garden, and doing handicraft work.

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