Target Refraction and Satisfaction of Patients with Binocular Myopia and Monocular Cataract

Young Kwon Chung; Jong Kyoung Na; Man Soo Kim

doi:10.3341/jkos.2014.55.6.817

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Chung, Na, and Kim: Target Refraction and Satisfaction of Patients with Binocular Myopia and Monocular Cataract

Original Article

J Korean Ophthalmol Soc 2014;55(6):817-825.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.6.817

Target Refraction and Satisfaction of Patients with Binocular Myopia and Monocular Cataract

Young Kwon Chung, MD, Jong Kyoung Na, MD, Man Soo Kim, MD, PhD

Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Man Soo Kim, MD, PhD, Department of Ophthalmology, The Catholic University of, Korea Seoul St. Mary's Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea, Tel: 82-2-2258-6197, Fax: 82-2-599-7405, E-mail: mskim@catholic.ac.kr

Received 18 October 2013 Revised 10 January 2014 Accepted 15 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the target refraction of patients with binocular myopia and monocular cataract after intraocular lens (IOL) implantation.

Methods

This study comprised 199 patients with binocular myopia (axial length >25 mm) and monocular cataract after IOL im-plantation for the removal of the monocular cataract. The research was conducted using a questionnaire method and by performing statistical analysis of the refractive outcomes.

Results

The patients are grouped into 3 domains (<-3 D group, −3∼-6 D group, >-6 D group). There were no statistically sig-nificant differences among the 3 groups; whereas the satisfaction of the present corrected state was statistically low in the >-6 D group (p < 0.05). The satisfaction of the corrected state was statistically high in the group of postoperative anisometropia under 3 D (p < 0.05). There was no statistical difference between the groups on the satisfaction of target diopter (-2∼-3 D or emme-tropia). In terms of correction method, glasses were worn in 119 patients (60%), contact lenses were worn in 26 patients (13%), and monovision was used in 14 patients (7%) were used respectively. Forty patients (20%) with implanted IOL in both eyes did not use any of the correction methods above. Except for the contact lens group, the general satisfaction and the satisfaction of the present corrected state were statistically lower than the other group (p < 0.05). There was no statistically significant differ-ence among the 3 groups in the percentage of cataract surgery in the fellow eye.

Conclusions

There was no statistical difference between the groups in satisfaction of target diopter (-2∼-3 D or emmetropia). Setting the target refraction difference between both eyes less than 3 D leads to more satisfactory outcomes.

Keywords: Cataract, Myopia, Satisfaction, Target refraction

References

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Figure 1.

Receiver operating characteristic (ROC) curve. *The refractive difference with the other eye; ^†Postoperative spher-ical equivalent; ^‡Preoperative spherical equivalent; ^§The re-fractive amount of the other eye.

Figure 2.

The correction methods to overcome anisometropia.

The other eye.

Table 1.

Demographics of the study group

No. of patients (eyes)	199
Mean age (years)	57.59 ± 11.33
Sex (Male/Female)	101/98
Preoperative refraction (diopter)	-7.77 ± 5.78 (-1.75∼-22.75)
Preoperative refraction of the other eye (diopter)	-6.00 ± 4.87 (0.50∼-25.5)
Axial length (mm)	26.93 ± 1.98 (25.01-31.41)
Preoperative BCVA (log MAR)	0.53 ± 0.24 (0.0-2.0)
Postoperative BCVA (log MAR)	0.16 ± 0.22 (0.0-0.5)
Postoperative refraction (diopter)	-1.99 ± 1.08 (-4.50∼+1.25)
Postoperative refractive difference with the other eye (diopter)	4.09 ± 4.79 (0-24.5)
Target diopter (diopter)	−1.84 ± 0.99 (−3.19∼ −0.19)
The general satisfaction score about the surgery	4.26 ± 0.67
The satisfaction score about correction state	3.89 ± 0.78

Values are presented as mean + SD.

BCVA = best corrected visual acuity.

Table 2.

The amount of preoperative refraction

Group	≤-3.0 D	-3.0 ∼-6.0 D	>-6.0 D
Preoperative refraction (diopter)	38 cases (19.1%)	70 cases (35.2%)	91 cases (45.7%)
	-2.09 ± 0.91	-4.60 ± 0.86	-12.47 ± 5.42
Mean age (years)	60.61 ± 11.07	56.89 ± 11.35	56.88 ± 11.34
Male/Female	27/11	34/36	40/51
Axial length (mm)	25.58 ± 0.67	26.04 ± 0.80	28.17 ± 2.24
Target refraction (diopter)	-1.52 ± 0.96	-2.06 ± 0.89	-2.16 ± 0.84
Postoperative refraction (diopter)	-1.60 ± 1.14	-2.20 ± 1.08	-1.99 ± 1.01
Postoperative refractive difference with the other eye (diopter)	1.38 ± 1.03	1.95 ± 1.55	6.82 ± 5.82

Values are presented as mean ± SD.

D = diopter.

Table 3.

The satisfaction score about the amount of preoperative refraction

Group	≤-3.0 D	-3.0∼-6.0 D	>-6.0 D
The general satisfaction score about the surgery	4.42 ± 0.55	4.27 ± 0.66	4.16 ± 0.70
The satisfaction score about the correction state	4.29 ± 0.57	3.97 ± 0.66	3.65 ± 0.86
The percentage of the patients whose general satisfaction score about the surgery was under 3 point	2.6%	11.3%	13.2%
The percentage of the patients whose satisfaction score about correction state was under 3 point	5.3%	19.7%	36.3%

Values are presented as mean ± SD.

D = diopter.

Table 4.

The satisfaction score about the selection of target refraction

Group	≤-2.0 D	>-2.0 D	p-value
Target refraction (diopter)	-2.63 ± 0.34	-0.87 ± 0.58
The general satisfaction score about the surgery	4.32 ± 0.65	4.18 ± 0.67	0.118
The satisfaction score about the correction state	3.98 ± 0.76	3.78 ± 0.80	0.071

Values are presented as mean ± SD.

D = diopter.

Table 5.

The satisfaction score about the amount of preoperative refraction and the target refraction

			Target refraction group
			≤-2.0 D	>-2.0 D	p-value
Preoperative refraction	≤-3.0 D	General satisfaction score	4.33 ± 0.62	4.47 ± 0.51	0.575
		Correction satisfaction score	4.26 ± 0.59	4.30 ± 0.56	0.883
	-3.0∼-6.0 D	General satisfaction score	4.35 ± 0.64	4.13 ± 0.68	0.184
		Correction satisfaction score	4.04 ± 0.70	3.83 ± 0.56	0.155
	>-6.0 D	General satisfaction score	4.24 ± 0.67	4.00 ± 0.74	0.121
		Correction satisfaction score	3.70 ± 0.88	3.53 ± 0.82	0.356

Values are presented as mean ± SD.

D = diopter.

Table 6.

The number of the patients grouped by the correction methods of anisometropia

Preoperative refraction	≤-3.0 D	-3.0∼-6.0 D	>-6.0 D	Total
Monovision	5 (13.2%)	5 (7.1%)	4 (4.4%)	14 (7.0%)
Glasses	28 (73.6%)	51 (72.9%)	40 (44%)	119 (59.8%)
Contact lens	0 (0%)	3 (4.3%)	23 (25.3%)	26 (13.1%)
TOE surgery	5 (13.2%)	11 (15.7%)	24 (26.3%)	40 (20.1%)
Total	38 (100%)	70 (100%)	91 (100%)	199 (100%)

D = diopter; TOE = the other eye.

Table 7.

The mean ages of the patients grouped by the correction methods of anisometropia

	≤-3.0 D	-3.0∼-6.0 D	>-6.0 D	Total
Monovision	64.60 ± 11.67	56.40 ± 8.85	56.25 ± 7.41	59.29 ± 9.78
Glasses	59.00 ± 10.74	57.80 ± 11.08	59.13 ± 9.44	58.53 ± 10.41
Contact lens	-	45.33 ± 4.16^*	49.65 ± 10.92^†	49.15 ± 10.41
TOE surgery	65.6 ± 12.24	56.00 ± 13.96	60.17 ± 12.59	59.70 ± 12.55

Values are presented as mean ± SD.

D = diopter; TOE = the other eye.

^* p-value = 0.031, 0.036, 0.170, Mann-whitney test;

^† p-value = 0.665, 0.006, 0.006, Mann-whitney test.

Table 8.

Comparisons of the preoperative and postoperative refraction differences on both eyes, the target refraction about the surgery, the correction state according to the correction methods of anisometropia

	Patients	Preoperative ref.	Postperative ref.	Postoperative refractive difference with the other eye	Target ref.
Monovision	14	-6.52 ± 5.55	-0.91 ± 1.03	3.20 ± 3.42	-1.17 ± 0.75
Glasses	119	-5.90 ± 4.03	-2.23 ± 0.98	2.02 ± 1.94	-2.06 ± 0.93
Contact lens	26	-15.16 ± 6.69	-1.95 ± 0.67	10.58 ± 6.07	-1.71 ± 1.04
TOE surgery	40	-8.84 ± 5.69	-1.68 ± 1.29	6.26 ± 5.57	-1.41 ± 1.00

Values are presented as mean ± SD.

TOE = the other eye; Ref. = refraction.

Table 9.

The satisfaction score about the surgery and the correction state according to the correction methods of anisometropia

	The general satisfaction score about the surgery	The satisfaction score about the present correction state
Monovision	4.43 ± 0.65	4.43 ± 0.51
Glass	4.40 ± 0.56	4.08 ± 0.66
Contact lens	4.08 ± 0.85	3.65 ± 0.69
TOE surgery	3.85 ± 0.66	3.25 ± 0.84

Values are presented as mean ± SD.

TOE = the other eye.

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