Patient Satisfaction With Monofocal And Advanced Technology Intraocular Lenses (Iol): Correlation Analysis Of Digitalized Proms

To determine the factors affecting patient satisfaction following implantation of various types of intraocular lenses using patient reported outcome measures (PROMs) in the RayPRO database (Rayner, Worthing, UK). This study investigates the relationship between patient satisfaction and visual quality or spectacle independence with monofocal, enhanced monofocal, extended depth of focus (EDOF), and multifocal (MF) IOLs.

Setting:

Multicenter survey conducted in 183 medical centers across 22 countries.

Patients enrolled in RayPRO were independently surveyed by the RayPRO platform via anonymous email questionnaires. PROMs collected were satisfaction with cataract surgery outcome, spectacle independence for distance, intermediate, and near vision, and day and night dysphotopsia. Pearson’s correlation analysis was performed, stratified by the most common models of each IOL type entered in the RayPRO database: Monofocal IOLs – Acrysof IQ (Alcon Inc., USA), RayOne Aspheric/Spheric/Toric (Rayner, UK), Tecnis      Eyhance (Johnson & Johnson Vision, USA); EDOF IOLs – Acrysof IQ Vivity (Alcon), Enhanced monofocal IOL RayOne EMV/ EMV Toric,; MF IOL – RayOne Galaxy & Trifocal (Rayner). Results at 3 months are presented.

5697 patients and 95 IOL models were enrolled. In all IOL types, satisfaction was negatively correlated with dysphotopsia (day/night), ranging from r=-0.420/ r=-0.389 (RayOne Spheric; p<0.001) to r=-0.749/ r=-0.638 (RayOne Trifocal; p<0.001); among EDOFs, RayOne Galaxy had the lowest correlation between satisfaction and dysphotopsia. Satisfaction was positively correlated with spectacle independence at distance (from r=0.194, p=0.001 [RayOne EMV Toric] to r=0.378, p=0.003 [RayOne Galaxy]), intermediate (from r=0.161, p=0.020 [RayOne Toric] to r=0.322, p<0.001 [RayOne Trifocal]), and near range (from r=0.156, p<0.001 [RayOne EMV] to r=0.321, p<0.001 [RayOne Trifocal]).

Patient satisfaction was more strongly influenced by dysphotopsia than by spectacle independence with monofocal IOLs. The negative correlation between dysphotopsia and satisfaction was strongest with the trifocal IOL, suggesting that monofocal and EDOF IOLs may be more forgiving of visual disturbances compared to trifocal IOLs. Among EDOFs as well as with the new RayOne Galaxy spiral IOL, the relatively low correlation between satisfaction and dysphotopsia demonstrates that continued technological refinements can achieve continuous vision while minimizing dissatisfaction due to visual disturbances.