Visual Outcome and Patient Satisfaction after Implantation of Multifocal IOLs: Three-Month Follow-Up Results

Sung Min Kim; Chi Hoon Kim; Eui-Sang Chung; Tae-Young Chung

doi:10.3341/jkos.2012.53.2.230

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Kim, Kim, Chung, and Chung: Visual Outcome and Patient Satisfaction after Implantation of Multifocal IOLs: Three-Month Follow-Up Results

Original Article

Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(2): 230-237.

Published online: 15 February 2012

DOI: https://doi.org/10.3341/jkos.2012.53.2.230

Visual Outcome and Patient Satisfaction after Implantation of Multifocal IOLs: Three-Month Follow-Up Results

Sung Min Kim, MD¹, Chi Hoon Kim, MD², Eui-Sang Chung, MD, PhD¹, Tae-Young Chung, MD, PhD¹

¹Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

²Chung-ju Eye Clinic, Chungju, Korea.

Address reprint requests to Tae-Young Chung, MD, PhD. Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3569, Fax: 82-2-3410-0074, tychung@skku.edu

Received 7 June 2011 Accepted 2 December 2011

Abstract

Purpose

To evaluate the visual outcome and patient satisfaction at three months after implantation of ReSTOR® Aspheric multifocal IOL D1 (+3.0 D) and D3 (+4.0 D) in unilateral and bilateral cataract surgery groups.

Methods

Among 73 patients who received cataract surgery and implantation of D1 or D3, visual outcome and satisfaction score of 34 patients in the unilateral surgery group and 39 patients in the bilateral surgery group were analyzed respectively. The unilateral surgery group was divided into 2 sub-groups (D1, D3), and the bilateral surgery group was sub-divided into 3 groups (D1/D1, D1/D3, D3/D3) according to the combination of implanted IOL. Uncorrected near visual acuity (UNVA, 30 cm), uncorrected intermediate visual acuity (UIVA, 40 cm, 50 cm), uncorrected distant visual acuity (UDVA) and best corrected visual acuity (BDVA) were measured at three months postoperatively. Also, all patients answered questionnaires to assess satisfaction.

Results

In the unilateral surgery sub-groups, visual acuity of the D1 group was higher than that of the D3 group at 50 cm (p < 0.001), although the D3 group showed better visual outcome at 30 cm (p < 0.001). In satisfaction analysis, the D1 group reported significantly higher scores in three categories (general satisfaction with surgery; p = 0.027, intermediate vision; p < 0.001, recommendation to others; p = 0.026). Among the bilateral surgery groups, the D1/D1 group showed the best intermediate visual acuity at 50 cm (p = 0.011), and the D3/D3 group achieved the highest postoperative near visual acuity (p = 0.004). In satisfaction analysis, the scores of the three categories (general satisfaction with surgery; p = 0.008, intermediate vision; p < 0.001, recommendation to others; p = 0.006) showed significant differences among the three groups, with the D1/D1 group reporting the highest scores in all three categories.

Conclusions

In bilateral ReSTOR® lens implantation, insertion of D1 in both eyes is expected to achieve the most favorable visual outcome and patient satisfaction. In unilateral ReSTOR® lens implantation, implantation of D1 rather than D3 would be more advantageous in general.

Keywords: Multifocal IOL, ReSTOR D1, ReSTOR D3, Satisfaction

Figures and Tables

Table 1

Preoperative characteristics of unilateral ReSTOR® insertion groups^*

Values are given as mean ± SD or number.

D1 = SN6AD1(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA); D3 = SN6AD3(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA).

UDVA = uncorrected distance visual acuity; BDVA = best corrected distance visual acuity.

^*Mann-Whitney U-test; ^†Astigmatism: measured by ORB scan (Bausch & Lomb, Rochester, NY, USA).

Table 2

Postoperative distance, intermediate, and near visual acuities of unilateral ReSTOR® insertion groups^*

Values are given as mean ± SD.

D1 = SN6AD1(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA); D3 = SN6AD3(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA).

UDVA = uncorrected distance visual acuity; BDVA = best-corrected distance visual acuity; UIVA = uncorrected intermediate visual acuity; UNVA = uncorrected near visual acuity.

^*Mann-Whitney U-test.

Table 3

Comparison of patients' satisfaction scores^* of unilateral ReSTOR® insertion groups^†

Values are given as mean ± SD.

D1 = SN6AD1(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA); D3 = SN6AD3(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA).

^*Satisfaction score: score measured by Likert scale; ^†Mann-Whitney U-test.

Table 4

Preoperative characteristics of bilateral ReSTOR® insertion groups^*

Values are given as mean ± SD or number.

D1 = SN6AD1(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA); D3 = SN6AD3(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA).

UDVA = uncorrected distance visual acuity; BDVA = best corrected distance visual acuity.

^*Kruskal-Wallis test; ^†Astigmatism: measured by ORB scan (Bausch & Lomb, Rochester, NY, USA).

Table 5

Postoperative distance, intermediate, and near visual acuities of bilateral ReSTOR® insertion groups^*

Values are given as mean ± SD.

D1 = SN6AD1(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA); D3 = SN6AD3(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA).

UDVA = uncorrected distance visual acuity; BDVA = best-corrected distance visual acuity; UIVA = uncorrected intermediate visual acuity; UNVA = uncorrected near visual acuity.

^*Kruskal-Wallis test, Tukey's post hoc test; ^†D1/D1 vs. D1/D3, p = 0.024; D1/D1 vs. D3/D3, p = 0.005; D1/D3 vs. D3/D3, p = 0.338; ^‡D1/D1 vs. D1/D3, p = 0.080; D1/D1 vs. D3/D3; p = 0.001; D1/D3 vs. D3/D3, p = 0.196.

Table 6

Comparison of patients' satisfaction scores^* of bilateral ReSTOR® insertion groups^†

Values are given as mean ± SD.

D1 = SN6AD1(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA); D3 = SN6AD3(AcrySof® IQ ReSTOR® Aspheric IOL, Alcon Lab., Fort Worth, TX, USA).

^*Satisfaction score: score measured by Likert scale; ^†Kruskal-Wallis test, Tukey's post hoc test; ^‡D1/D1 vs. D1/D3, p = 0.144; D1/D1 vs. D3/D3, p = 0.005; D1/D3 vs. D3/D3, p = 0.320; ^§D1/D1 vs. D1/D3, p = 0.014; D1/D1 vs. D3/D3, p < 0.001; D1/D3 vs. D3/D3, p = 0.246; ^∥D1/D1 vs. D1/D3, p = 0.049; D1/D1 vs. D3/D3, p = 0.004; D1/D3 vs. D3/D3, p = 0.568.

Appendix

Postoperative questionnaires on satisfaction

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