Wilkes Barre, PA (April 13, 2018, 8:00 AM EST) More than 20 million cataract surgeries are performed annually worldwide. Many of these cataract patients request good vision at all distances without eyeglass dependence. Now, research at Bucci Laser Vision Institute has found how to reach greater patient satisfaction with low add multifocal intraocular lenses (IOLs), specifically TECNIS® Multifocal Intraocular Lenses*. Results were presented at the American Society of Cataract and Refractive Surgery (ASCRS) and American Society of Ophthalmic Administrators (ASOA) Annual Symposium & Congress 2018 (ASCRS•ASOA Annual Symposium & Congress) in Washington, D.C. from April 13 to 17.
“With lower add powers, surgeons, like me, have the ability to personalize outcomes for their cataract patients based on lifestyles and preference for distance, near, and intermediate vision,” said Frank Bucci, Jr., MD, founder of Bucci Laser Vision Institute and lead author of the study. “In this study, we found that the newer generation of low add multifocal intraocular lenses dramatically increased patient satisfaction because of improved intermediate vision function with no sacrifice at near or distance vision.”
This multiple regression analysis compared the performance of bilateral +4.00 multifocal IOLs to bilateral +3.25 multifocal IOLs. In the analysis, “overall patient satisfaction” acted as the dependent variable and was regressed against 40 independent variables including 31 clinical metrics such as reading speed, reading accuracy, residual astigmatism, pupil size, and uncorrected vision at near, intermediate, and distance. Patient responses to a questionnaire evaluating their visual responses represented 9 quantifiable variables.
A statistically significant increase in “very satisfied” patients was observed in the bilateral +3.25 cohort (n=67) compared to the bilateral +4.00 cohort (n=55). For the +4.00 patients, 64% were “very satisfied” and 36% were “satisfied”. The percentage of “very satisfied” patients significantly increased to 82% (p=0.01) and the percentage of “satisfied” patients was 18% in the +3.25 cohort. The dramatic increase was likely due to the 17” focal length for the +3.25 patients compared to a 14” focal length for the +4.00 patients. In the +4.00 study, regression analysis revealed that less than optimum “intermediate vision” was responsible for lower satisfaction scores compared to the +3.25 patients. Interestingly, the questionnaire data for the +3.25 group revealed significantly higher scores for intermediate vision (p=0.02) without sacrificing any performance at near.
Regression analysis also revealed that mesopic pupil size was a significant “predictor” of intermediate vision because both implants contain a central 1.00 mm button which is half the overall add power of the multifocal IOL. The smaller the pupil, the better the intermediate vision, because a greater percentage of light is going through the central 1.00 mm zone.
“As such, mesopic pupil size is a valuable predictor of the post-operative intermediate visual performance and should be analyzed as part of pre-operative surgical strategies moving forward,” said Dr. Bucci.
*TECNIS® is a trademark of Johnson & Johnson Surgical Vision, Inc.
All educational content of the ASCRS•ASOA Annual Symposium & Congress is planned by its program committee, and ASCRS•ASOA does not endorse, promote, approve, or recommend the use of any products, devices, or services.