Multidimensional Visual Function Changes Before And After Cataract Surgery: Radar Chart Analysis Of Monofocal And Multifocal Intraocular Lenses.

To analyze changes in overall visual function in cataract surgery from pre- to postoperative, visually illustrated using a radar chart, and to explore the predictive capability of preoperative evaluation for postoperative visual performance and patient satisfaction with monofocal and multifocal intraocular lenses (IOLs).

Ophthalmology Department of University Hospital of Coimbra, Unidade Local de Saúde de Coimbra, Portugal.

A prospective observational cohort study was designed, including patients aged 40 to 70 years with cataracts who underwent consecutive bilateral cataract surgery with implantation of monofocal, extended depth of focus (EDOF), and trifocal diffractive IOLs.

All patients underwent a comprehensive ophthalmological evaluation, including auxiliary exams for long-term safety prediction; distance, intermediate, and near visual acuities (VA); refraction; stereopsis; reading speed; contrast sensitivity function with and without glare; CatQuest-9SF and Quality of Vision (QoV) questionnaires; negative dysphotopsia assessment; Light Disturbance Analyzer (LDA); and iTrace aberrometry; all performed both pre- and at the 4th month postoperatively.

We included 208 eyes from 104 consecutive patients (n=104) with mean age 59.3 ± 7.9 years: 47 received a trifocal IOL, 40 an EDOF IOL, and 17 a monofocal IOL. All groups showed significant improvement in best corrected VA at all distances, stereopsis, reading speed, and CatQuest-9SF scores, with the trifocal group achieving the best outcomes. QoV scores were highest in the trifocal group, followed by EDOF and monofocal. All groups had a significant reduction in Light Disturbance Index (LDI) from LDA. Lower preoperative LDI was correlated with higher postoperative QoV in EDOF and trifocal groups. Radar graphs illustrating median values demonstrated multidimensional visual function changes before and after surgery for each IOL group.

This study characterizes overall visual function changes after consecutive bilateral cataract surgery with monofocal and multifocal IOLs. Overall patient satisfaction was high, with trifocal IOL subjects achieving the highest scores but also reporting the most positive dysphotopsia. Low preoperative LDI values may predict higher postoperative dysphotopsia perception with EDOF and trifocal IOLs. A radar chart illustrates overall visual function, aiding in patient satisfaction interpretation, outcome prediction, and visual comparison of different IOL types and different stages in patients' conditions.