ESCRS - FP32.01 - Patient Satisfaction And Regression Analysis In Patients Receiving A Light Adjustable Lens In The Dominant Eye And A Multifocal Iol In The Non-Dominant Eye

Patient Satisfaction And Regression Analysis In Patients Receiving A Light Adjustable Lens In The Dominant Eye And A Multifocal Iol In The Non-Dominant Eye

Published 2025 - 43rd Congress of the ESCRS

Reference: FP32.01 | Type: Free paper | DOI: 10.82333/46ta-xx31

Authors: Nicolás Kahuam López* 1 , Mauricio Muleiro Alvarez 1 , Guillermo R. Vera-Duarte 1 , Gustavo Ortiz-Morales 1 , Luis Haro-Morlett 1 , Ruth Eskenazi-Betech 1 , Alejandro Navas 1 , Arturo Ramirez-Miranda 1 , Denise Loya-Garcia 1 , Enrique O. Graue-Hernandez 1

1Cornea and Refractive Surgery,Instituto de Oftalmologia Conde de Valenciana,Mexico City,Mexico

Purpose

Evaluate patient satisfaction and use regression to identify objective variables that are significant predictors of “overall patient satisfaction”, and answer the question:  Will the potential benefits of an LAL (less halos, less HOAs, and improved contrast sensitivity) more than compensate for decreased near vision as a result of replacing 1 multifocal IOL with an LAL.

Setting

Bucci Laser Vision Institute, Wilkes-Barre, Pennsylvania, USA

Methods

Clinical outcomes and data for 24 LAL/multifocal cataract patients was collected including uncorrected distance, intermediate, and near visual acuities, manifest refraction, BCDVA, reading speed and acuity, and contrast sensitivity. A subjective questionnaire explored frequency of glasses use for visual function at near, intermediate, and distance, and frequency and severity of dysphotopsias. Angle kappa, asphericity, higher order aberrations, mesopic and photopic pupil size, and residual spherical and astigmatism were also evaluated.

Multivariate regression analysis was used to detect which variables were significant predictors of  the dependent variable “overall patient satisfaction.

Results

24 pts (LAL/Multi) were evaluated. 54.2% were “very satisfied” and 45.8% were “satisfied”. Regression detected 5 sig predictors of “overall patient satisfaction.” The equation (R2 of .78) was:“Overall Patient Satisfaction” = +4.13 +(0.27)Near (fine print)  +(0.95) +HOAs +(0.06)Light at Night (severity) +(0.01)Con Sens-meso w/glare)  +(0.18) Distance VAsc. Jaeger near vision was 1.29 (multi eyes) vs 3.04 (LAL eyes). Ranked 0-10, light at night was sig less (p=0.012) in LAL eyes (1.63) vs Multi eyes (3.29). 15 of 16 contrast sens variables were sig better in the LAL eyes vs the multi eyes. Distance VAsc trended better (p=.07) in the LAL eyes (20/21.47) vs the multi eyes (20/23.32).

 

Conclusions

:1) Satisfaction and regression data support the thesis that the benefits of using one LAL with a multifocal may more than compensate for the decrease in near vision vs two multifocals  2)Four of the 5 significant contributors to satisfaction (HOAs, contrast sens, light severity/night, and VAsc-dist)can be directly linked to the use of an LAL