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R.M. Nuyts, M.D. Nijkamp, J. De Brabander, B. van den Borne, F. Hendrikse; Patient Satisfaction After Cataract Surgery With Multifocal Intraocular Lenses to Correct Presbyopia . Invest. Ophthalmol. Vis. Sci. 2003;44(13):253.
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Purpose: Although monofocal intraocular lenses (IOLs) are effective in improving vision after cataract surgery, the loss of accommodation is not restored by implantation of these IOLs. Since multifocal IOLs may improve uncorrected distance and near vision, we compared the clinical outcome and patient satisfaction after implantation of monofocal and multifocal IOLs. Besides outcome measures, socio-demographics, eagerness for spectacle independence (ESI), and neuroticism were tested as predictors of satisfaction. Methods: 75 patients with monofocal and 78 patients with multifocal IOLs were followed in a randomised controlled trial. Assessments were made preoperatively (t1), 3 months after first (t2) and 3 months after second eye surgery (t3). Primary outcomes consisted of near and distance visual acuity. Secondary outcomes related to spectacle dependence, vision related functioning and patient satisfaction. Results: Multifocal IOLs showed better uncorrected near visual acuity (p<0.01), higher quality ratings of unaided near vision over time (p<0.01), and reduced spectacle dependence at t3 for near (p=0.002) and distance (p=0.001). Monofocal IOLs showed less bother from cataract symptom scores (p< 0.001). Because of high preoperative expectations, the percentage of satisfied patients was relatively low: 62.5% in the monofocal and 61.5% in the multifocal group (p=NS). The perceived quality of corrected near vision had the strongest relationship with patient satisfaction (r=0.26, beta=0.22). Socio-demographics, ESI and neuroticism did not predict patient satisfaction. Conclusions: Although mono-and multifocal IOLs showed to have their own advantages and disadvantages, overall patient satisfaction did not differ between the two groups. Independent of ESI or neuroticism scores, success of both IOLs depends on preoperative expectations and postoperative quality of aided near vision.
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