Patient-Centered and Visual Quality Outcomes of Premium Cataract Surgery: A Systematic Review

Wang, Sophia Y.; Stem, Maxwell S.; Oren, Gale A.; Shtein, Roni M.; Lichter, Paul R.

doi:10.5301/ejo.5000978

Cited by 77 publications

(89 citation statements)

References 89 publications

(193 reference statements)

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“…CS improved with time and achieved an age normal range of 3-12 months after surgery. Similar results were presented in the meta-analysis by Rosen et al [32] and in the review by Wang et al [33]. Thus, doubts remain as to which MIOL design would offer the best visual performance and patient satisfaction in patients with retinal disease.…”

Section: Cs and Miolssupporting

confidence: 72%

Multifocal intraocular lenses and retinal diseases

Grzybowski

Kanclerz²,

Tuuminen

2020

Graefes Arch Clin Exp Ophthalmol

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Purpose Multifocal intraocular lenses (MIOLs) are often discouraged in patients with or at risk of retinal disorders (including diabetic retinopathy, age-related macular degeneration, and epiretinal membranes), as MIOLs are believed to reduce contrast sensitivity (CS). Concerns with MIOLs have also been raised in individuals with visual field defects, fixation instability or eccentric preferred retinal locations. The aim of this study is to review the influence of MIOL on quality of vision in patients with retinal diseases. Methods We reviewed the PubMed and Web of Science databases to identify relevant studies using the following keywords: multifocal intraocular lens, cataract surgery, cataract extraction, lens exchange, diabetic retinopathy, age-related macular degeneration, and contrast sensitivity. Results Studies evaluating CS in MIOLs present conflicting results: MIOLs either did not influence CS or resulted in worse performance under low-illuminance conditions and higher spatial frequencies when compared to monofocal IOLs. Nevertheless, MIOLs preserved CS levels within the age-matched normal range. Two studies reported that patients with concurrent retinal diseases receiving a MIOL, both unilaterally and bilaterally, reported a significant improvement in visual-related outcomes. Individuals with a monofocal IOL in one eye and a MIOL in the fellow eye reported greater subjective satisfaction with the MIOL. Conclusion We were unable to find evidence suggesting that patients with retinal diseases should be advised against MIOLs. Nevertheless, more research is needed to address the aforementioned concerns and to optimize the use of MIOLs in eyes with retinal disease.

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Section: Cs and Miolssupporting

confidence: 72%

Multifocal intraocular lenses and retinal diseases

Grzybowski

Kanclerz²,

Tuuminen

2020

Graefes Arch Clin Exp Ophthalmol

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“…In contrast, patient dissatisfaction with the pseudophakic mini-monovision technique is mostly related to the refractive outcome, which can be corrected with spectacles or contact lenses and does not require additional surgery. A systematic review of research on quality outcomes revealed that patients with multifocal IOLs are more likely than patients with pseudophakic mini-monovision technique to undergo IOL exchange due to dissatisfaction with image quality [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost

Goldberg

Shah

et al. 2018

BMC Ophthalmol

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BackgroundCataract surgery with pseudophakic mini-monovision has lower out-of-pocket patient expense than premium multifocal intraocular lenses (IOL). The purpose of this study was to evaluate patient-reported satisfaction and spectacle dependence for key activities of daily living after cataract surgery with pseudophakic mini-monovision. The study also examined statistical relationships between patient demographic variables, visual acuity and satisfaction.MethodsProspective cohort study of 56 patients (112 eyes) who underwent bilateral cataract surgery with pseudophakic mini-monovision. Mini-monovision corrects one eye for distance vision and the other eye is focused at near with − 0.75 to − 1.75 D of myopia. All patients with 1 diopter or greater of corneal astigmatism had a monofocal toric IOLs implanted or limbal relaxing incision. The main study outcomes were assessed at the last follow-up appointment and included refraction, visual acuity, patient reported spectacle use, and patient satisfaction. Descriptive statistics, correlation matrixes and Pearson’s chi-square tests were examined.ResultsUncorrected visual acuity was significantly better post-operatively. Most patients reported the surgery met their expectations for decreased dependence on spectacles (93%). Most patients report little or no use of spectacles post-operatively for computer use (93%), distance viewing (93%) and general use throughout the day (87%). A small number of patients report spectacle use for reading (9%) and night driving (18%). There were no relationships detected between demographic variables and visual acuity or patient satisfaction.ConclusionsAging of the population presents one of the biggest challenges in the health sector, which includes a rising number of individuals with chronic vision impairment and increased demand for accessible treatment strategies. Cataract surgery with pseudophakic mini-monovision results in high patient satisfaction and considerable reduction in spectacle dependence. Pseudophakic mini-monovision technique is a low-cost, valuable option for patients who would like to reduce dependence on spectacles post-operatively and should be considered along with premium multifocal IOLs in options available for patients based on their needs, preferences and clinical indicators. Reducing spectacle dependence with the pseudophakic mini-monovision technique could improve the functionality, independence and quality of life for many patients who are unsuitable or are unable to pay additional fees associated with premium multifocal IOLs.

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“…[1][2][3] With recent developments in intraocular lens (IOL) and biometry technology, stand-alone cataract surgery now provides a substantial opportunity to increase optical independence and vision-related quality of life. 4 Given this, patient expectations have similarly increased. Despite often long-term ophthalmic care, glaucoma patients would appear to hold similar expectations of an improved range of vision following cataract surgery.…”

Section: Introductionmentioning

confidence: 99%

<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>

Ioannidis

Töteberg‐Harms

Hamann

et al. 2020

OPTH

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Purpose: Simultaneous cataract and glaucoma surgery has traditionally been challenging for the anterior segment surgeon. The introduction of minimally invasive glaucoma surgery (MIGS) in conjunction with cataract surgery appears safe and effective in lowering intraocular pressure. Although a significant visual impact leading from the combined procedure is unexpected, we aim to describe the refractive outcomes in a cohort of patients undergoing simultaneous cataract removal and iStent inject and discuss the potential implications of combined surgery in patients with co-existent glaucoma. Patients and Methods: This is a retrospective consecutive case series inclusive of patients undergoing combined femtosecond laser-assisted cataract surgery and the insertion of two trabecular micro-bypass stents (iStent inject). Visual acuity, refraction and astigmatic vector analysis were collated and analysed from the preoperative and 4 weeks postoperative visits. Results: One hundred and six eyes of 89 patients from 2 surgeons were included in the original cohort. The mean absolute difference from target refraction was 0.36 ± 0.25D. 73.9% of eyes were within ± 0.5D of the refractive target and 98.9% of eyes were within ± 1.00D. 73.8% of eyes had 0.5D or less residual refractive astigmatism following the procedure. Conclusion: We present a novel cohort of glaucoma patients undergoing combined trabecular micro-bypass stents (iStent inject) and cataract surgery achieving excellent refractive outcomes. The results of this study indicate that this second-generation device is refractively neutral.

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Patient-Centered and Visual Quality Outcomes of Premium Cataract Surgery: A Systematic Review

Cited by 77 publications

References 89 publications

Multifocal intraocular lenses and retinal diseases

Multifocal intraocular lenses and retinal diseases

Pseudophakic mini-monovision: high patient satisfaction, reduced spectacle dependence, and low cost

<p>Refractive Outcomes After Trabecular Micro-Bypass Stents (iStent <em>Inject</em>) with Cataract Extraction in Open-Angle Glaucoma</p>

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