Presbyopic Refractive Lens Exchange With Trifocal Iols: Net Promoter Score And Spectacle Independence Based On Preoperative Refraction And Work Activity
Published 2025 - 43rd Congress of the ESCRS
Reference: FP32.02 | Type: Free paper | DOI: 10.82333/qzgf-ma42
Authors: Ömer Mustafa Bilgiç* 1 , Deniz Alptekin 1 , Özlem Evren Kemer 1 , Yasin Toklu 2
1Ophthalmology,University of Health Sciences: Bilkent City Hospital,Ankara,Türkiye, 2Ophthalmology,Yıldırım Beyazıt University,Ankara,Türkiye
Purpose
To analyze the impact of preoperative refraction and work activity on patient-reported outcomes and spectacle independence after presbyopic refractive lens exchange with trifocal IOL implantation.
Stratifying patients by refraction group and work activity helps assess the efficacy of trifocal IOLs across different patient profiles and set more realistic expectations during preoperative counseling.
Setting
Memira by Bergman Clinics. Norway, Sweden and Denmark.
Methods
Net Promoter Score (NPS) and Patient Reported Outcome Measures (PROM) questionnaires were collected from our database three months after refractive lens exchange (RLE) with trifocal IOL implantation for the treatment of presbyopia between 2020 and 2025.
The NPS and PROM data were then correlated with preoperative refraction (myopia, emmetropia, and hyperopia) and work activity (office, people-oriented, craftsman, outdoor, visually demanding tasks, and others) to assess the impact of these variables on patient satisfaction and spectacle independency.
Results
The NPS response rate was 46.4% (N=10,055 patients). The overall NPS was 59, and PROM analysis showed an 88% satisfaction rate.
Hyperopes were the most satisfied across all work activities (NPS=64), while people-oriented professions (e.g., professors, nurses, doctors) had the highest NPS across refraction groups (emmetropes: 58, hyperopes: 73). Emmetropes were the least satisfied overall (NPS=52), and myopes reported lower satisfaction in near-vision demanding jobs (NPS=44).
Complete spectacle independence was 92%: hyperopes (94%), emmetropes (91%), and myopes (90%). However, it varied in near-vision demanding jobs: myopes (74%), emmetropes (88%), and hyperopes (92%).
Conclusions
Overall satisfaction and spectacle independence were high following presbyopic refractive lens exchange with trifocal IOL implantation. Both preoperative refraction and work activity influenced patient-reported outcomes. The highest perceived benefit was observed in hyperopes and people-oriented professions. Emmetropes reported the lowest overall experience rating, despite outperforming myopes in near-vision demanding jobs / activities.
These findings can aid in patient counseling and help set more realistic expectations for the surgical correction of presbyopia with trifocal IOLs.