Exploring Vision-Related Quality of Life: A Qualitative Study Comparing Patients’ Experience of Cataract Surgery with a Standard Monofocal IOL and an Enhanced Monofocal IOL

Abstract

Purpose To explore quality of life related with intermediate vision of patients before and after cataract surgery, and to make patients’ experience available for the design of future scales that assess visual function related with intermediate distance. Patients and Methods A qualitative research methodology based on thematic content analysis was used to explore vision-related quality of life based on the experiences of patients with cataract. Patients were recruited at the Service of Ophthalmology of the Hospital de Sant Pau (Barcelona, Spain). Data were collected through nineteen semi-structured interviews conducted with patients diagnosed with cataract and implanted with a standard aspheric monofocal intraocular lens (IOL) (Tecnis ® ZA9003) (n = 6), an enhanced monofocal IOL (Tecnis ® Eyhance ICB000) (n = 6), and patients from the waiting list (n = 7). The data analysis consisted in coding, aggregation, and theme development of the transcribed audios. Results Patients on waiting lists reported difficulty and insecurity in performing daily and meaningful tasks related to near visual ranges (eg: threading a needle, reading price tags), intermediate (eg: using a computer or dialling numbers on a smartphone), and distant (eg: recognizing faces, walking on uneven surfaces). Patients after surgery with the standard IOL reported improvement in performing activities mainly in the distant visual range, but also the need for a better communication with clinical staff to adjust their own expectations on the results of the surgery. Finally, patients implanted with the enhanced IOL reported satisfaction and improved visual function in performing daily activities, especially those related to the intermediate visual range. Conclusion Our exploratory study found that patients after cataract surgery with the enhanced IOL reported a better performance in activities that require the intermediate vision. These results will inform the development of scales to assess vision-related quality of life in the intermediate visual range prioritizing outcomes according to patients’ daily and meaningful activities.

Comparison of visual outcomes of bilateral dual-technology diffractive intraocular lens vs blended enhanced monofocal with dual-technology intraocular lens

“…Although the literature reports favorable outcomes with these strategies, they may compromise near vision. [1][2][3][4][5][6][7][8] Some studies have analyzed the implantation of an EDOF IOL in the dominant eye and a trifocal IOL in the fellow eye, with good results, as an alternative to bilateral trifocal IOL. Another option is the implantation of a monofocal IOL in the dominant eye and a trifocal IOL in the nondominant eye.…”

“…However, several pseudophakic patients with monofocal IOL implants require reading spectacles to compensate for the loss of clear vision at intermediate or near distances. [1][2][3][4][5][6][7][8][9][10] Advanced IOL designs, including multifocal IOLs, are currently used in clinical practice to treat presbyopia in pseudophakic patients. [11][12][13][14][15] Most multifocal IOLs available in the market are equipped with either 2 optical zones, catering to distant and near vision, or 3 optical zones, accommodating distant, intermediate, and near vision.…”

Beyond vision:Cataract and health status in old age, a narrative review

“…Comparison of different intraocular lenses regarding visual impairment, visual function and patient satisfaction are becoming available ( 81 , 82 ). Similar studies addressing outcomes which are specifically relevant to older populations, such as fall incidence, depressive symptoms and cognitive impairment, are needed to guide clinicians’ choice.…”

Positioning of enhanced monofocal intraocular lenses between conventional monofocal and extended depth of focus lenses: a scoping review

“…Twenty-four were excluded because none of the IOLs described in the context were included, and only two papers were excluded because of comorbidities or different study types from those described in the inclusion criteria. After the full text evaluation, three clinical studies were excluded since the inclusion criteria was not accomplished, [11][12][13] and one mixed was maintained (partly excluded) since the criteria was accomplished in the laboratory study context but not in the clinical [14]. During the search update in the moment of data extraction, three papers were included, two not indexed in the databases and found through snowballing techniques, [15,16] and 1 new after search update [17].…”