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 2026 - 44th Congress of the ESCRS
Reference: POCAT473 | Type: Free paper | DOI: 10.82333/08wm-jb54
Authors: Dr Frank Bucci* 1
1Bucci Laser Vision Institute,Wilkes-Barre,United States
Purpose
1) Evaluate patient satisfaction and use regression analysis to identify objective variables that are significant predictors of “overall patient satisfaction” and answer the question: Will the potential qualitative benefits (HOAs, dysphotopsias, and CS) of an LAL+ more than compensate for decreased near vision as a result of replacing one multifocal IOL with an LAL+ ? 2) Compare the outcomes of this LAL+ study to a previous study with 27 LAL
(not +)/multifocal patients (ESCRS 2025), with specific emphasis on the influence of the LAL+ magnifier on contrast sensitivity (CS) and overall satisfaction.
Setting
Bucci Laser Vision Institute
Wilkes-Barre
Pennsylvania
United States
Methods
Clinical outcomes & data for 32 LAL+/multifocal cataract pts were collected including uncorrected visual acuities, HOAs, manifest refraction, reading speed & acuity, and photopic & mesopic CS with & w/o glare. A published subjective questionnaire explored frequency of glasses use for visual function at near, inter, & dist, and frequency & severity of dysphotopsias. Angle kappa, asphericity, mesopic & photopic pupil size, and residual sphere & astigmatism were also evaluated. Multivariate regression analysis was used to detect which variables were sig predictors of the dependent variable “overall patient satisfaction.” These results were compared to a previous study with identical methods which included 27 LAL (not +)/multifocal patients.
Results
32 pts (LAL+/Multi) were evaluated. 75.0% (vs. 54.2% LAL) were “very satisfied” and 21.9% (vs 45.8% LAL) were “satisfied”. Regression detected 5 sig predictors of “overall patient satisfaction.” The equation (R2of .89) was: “Overall Patient Satisfaction” = +3.51 +(-0.56) CS photo w/glare 3.0 cpd
+(-0.74) Dist VAsc +(1.27) CS meso w/glare +(-0.22) Intermed VAsc +(-0.35) CS photo w/glare 18.0 cpd. The mean near vision was J2 with LAL+ (vs J3 w/LAL), resulting in a 10% increase in reading speed (89.9 WPM w/ LAL+ vs 82.1 WPM w/LAL p=.003). The CS advantage over the multifocal eyes decreased when using LAL+ vs. LAL. 6 of 16 CS variables were sig better in the LAL+ eyes vs. multifocal eyes, compared to 15 of 16 CS variables with the LAL eyes
Conclusions
1) Outcomes again supported the thesis that the benefits of using one LAL (decreased HOAs & dyspotopsias & increased CS) with a multifocal more than compensates for the decrease in near vision vs two multifocals. 2) There was a sig increase (21%) in “very satisfied” patients with the LAL+(75.0%) vs the LAL (54.2%) with a 10% increase in bilateral reading speed. 3) Regression identified 3 CS variables as predictors of overall satisfaction. The CS advantage with LAL vs mutifocal IOLs decreased with use of the LAL+, likely due to adding a magnifier to the IOL optic. 4) It appears that the improved near visual function had a greater influence on overall satisfaction than the effects of decreased CS from the added magnifier of the LAL+ lens.