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Frank A Bucci, Breanne Michalek, Hope Fluet; A Comparison Using Multiple Regression Analysis of Patient Satisfaction with Bilateral +3.25 vs. Bilateral +4.00 Diffractive Multifocal IOLs at the Time of Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4796.
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© ARVO (1962-2015); The Authors (2016-present)
To detect and compare the predictors of “overall pt. satisfaction” with bilateral +3.25 vs. +4.00 diffractive multifocal IOLs
67 (+3.25/+3.25) “best case patients” with 1) 6 mo. neuroadaptation 2) corrected residual refractive error 3) necessary YAGs completed 4) aggressive ocular surface management, underwent regression analysis to identify predictors of “overall pt. satisfaction”. Satisfaction was regressed against 40 independent variables including 31 clinical metrics such as reading speed & accuracy, angle kappa, abberations, mesopic & photopic pupil size, residual sph. eq. & astigmatism, near, intermed. vision at fixed & preferred focal distances, etc., & 9 responses from a questionnaire evaluating the performance of everyday tasks. The results of the +3.25 study will be compared to a prior cohort with identical methods of 55 bilateral +4.00 pts.
82% (55/67) were “very satisfied” & 18% (12/67) were “satisfied” with bilateral +3.25 vs. 64%(very satisfied)/36% (satisfied). in the prev. bilateral +4.00 cohort (p=.01). In the +4.00 study, regression revealed 1) 3 variables related to intermed. vision were significant predictors of “overall pt. satisfaction” 2) smaller mesopic pupils (p=.005) and better centration (p=.02) predicted superior intermed. vision (beyond the pinhole effect) because of a 1.00mm central zone with ½ the total add power of the IOL.In the +3.25 cohort, regression again revealed that smaller mesopic pupils (p=.005) predicted significantly better intermed. vision because the +3.25 IOL also contains the 1.00mm central button with ½ the add power. Additional statistically significant improvements in intermed. vision scores were observed such as 3.59/5.00 (+3.25) vs. 2.94/5.00 (+4.00) (p=.005) for the variable of “arms length vision while on the computer.”
1) Bilateral +3.25 pts. revealed significantly greater pt. satisfaction vs. bilateral +4.00. 2) Improved intermed. vision (with no sacrifice at near or distance) was responsible for significantly greater pt. satisfaction. 3) The increased focal length of the +3.25 (17”) vs. the nearer focal length of the +4.00 (14”) is likely responsible for the significantly improved intermed. vision. 4) Regression revealed that mesopic pupil size was still a significant predictor of improved intermed. vision beyond the pinhole effect.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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