Evaluation Of Spectacle Independence With The Dutch Patient-Reported Spectacle Independence Questionnaire

The Patient-Reported Spectacle Independence Questionnaire (PRSIQ) is a patient-reported outcome measure that assesses what patients say about their need for spectacles, their use of spectacles in daily life, and how they function without spectacles. It contains a total of 11 questions about the need for, use of, and wearing of spectacles for distance, intermediate, and near vision. In this study, we evaluate spectacle independence with the Dutch translation of this questionnaire in healthy subjects and in cataract patients with implantation of different types of IOLs and targeted refractive errors. To this end, we present a dichotomous scoring and explore the potential for Rasch scoring of this instrument.

Amphia hospital, department of Ophthalmology, Breda, The Netherlands.

We included 50 healthy participants under 50 years and 50 healthy participants over 50. The questionnaire was also completed by participants who had undergone cataract surgery in both eyes. Both eyes received the same type of IOL and had the same targeted refractive error; monovision was not included. The sizes of the different groups included so far: 44 patients had monofocal (MF) IOLs (Vivinex), 50 enhanced MFs (Eyhance), 25 toric MFs (AcrySof, Tecnis, Eyhance), 37 MFs with a myopic target, 47 EDOFs (Symfony and Vivity), and 49 trifocals (PanOptix). Spectacle independence was assessed post-procedure at all distances with dichotomous scoring (yes/no) and across pre- and post-procedure visits with exploratory Rasch analysis.

Dichotomous scoring showed statistically different rates of complete spectacle independence: 57% for trifocals, 17% for EDOFs, 5% for MFs, 4% for toric MFs, 2% for enhanced MFs and 0% for myopic targets. Mean ± SD exploratory Rasch scores were: MFs -0.30 ± 0.62, enhanced MFs -0.34 ± 1.14, toric MFs -0.09 ± 0.61, MFs with myopic target -0.77 ± 0.87, EDOFs 0.54 ± 0.48 and trifocals 0.99 ± 0.42. EDOF and trifocal patients were statistically significantly (Tukey HSD) less dependent on spectacles than all other groups, except EDOFs compared to torics. Difference in spectacle independence between patients with EDOF and trifocal IOLs was not significant. Rasch score for healthy subjects under 50 was -0.46 ± 1.50; for over 50: -1.55 ± 1.78.

We evaluated the Dutch translation of the Patient-Reported Spectacle Independence Questionnaire (PRSIQ-NL). Dichotomous scoring and preliminary Rasch analysis demonstrated a difference in self-reported spectacle independence between the different IOL types and target refractive errors. Patients with trifocal IOL implantation in both eyes show the highest spectacle independence, followed by EDOF IOLs although these groups were not significantly different. Those with a target of myopia reported to be most dependent on spectacles. Overall, healthy subjects over 50 are most spectacle dependent. We believe that the PRSIQ-NL may be useful in analysing the results of different IOLs and refractive targets.