A Survey Of Intraocular Lens Preferences For Refractive Surgery In Uk Consultants

To explore the opinions of UK refractive surgery consultants on the intraocular lenses (IOLs) used for refractive surgery

Online survey across the UK

An online survey was distributed to refractive surgery consultants across the UK on their use and preference of intraocular lenses for refractive surgery including typical cataract surgery, refractive lens exchange (RLE), extended depth of focus (EDoF) lenses, toric IOLs and multifocal IOLs.

There was an 85% response rate. The overall preferred IOL choice for cataract surgery was a tie between monofocal & EDoF (27%), followed by trifocal (24%). Main reasons cited were: fewer unwanted symptoms, better overall visual outcomes & reduced spectacle independence, respectively. In presbyopic patients over the age of 50, preferred IOL choice for typical RLE was a tie between EDoF & trifocal (38%). Main reasons cited were better overall visual outcomes & reduced spectacle independence.

43% of respondents would prefer to implant a toric IOL for astigmatism of <1D and 24% for 1D or higher.

For mix and match of a trifocal/multifocal IOL with another IOL type, 29% use this for selected patients, & 57% would in general not recommend this.

This study suggests that there is currently no clear preferences for IOL choice for a ‘typical’ cataract surgery patient amongst our UK cohort of surgeons. For RLE in presbyopic patients, there was equal favour for EDoF and trifocal IOLs. Most respondents had a low threshold for using a toric IOL in the presence of corneal astigmatism, even at magnitudes under 1 D. This might suggest a diminished role of other astigmatic procedures (e.g. Limbal relaxing incisions) in cataract/RLE surgery. Finally, mix and match of trifocal/multifocal IOLs with other types of IOLs does not seem to be common practice.