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Kristin Hirabayashi, Julie M. Schallhorn, Steve Schallhorn, Stephen Hannan; Patient-Reported Visual Symptoms after Refractive Lens Exchange. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5978. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the incidence of patient-reported visual symptoms 1 month and 3 months after refractive lens exchange.
This was a retrospective case series studying patients with preoperative best corrected visual acuity (BCVA) of 20/40 or better who underwent femtosecond laser-assisted phacoemulsification for refractive indications between July 1, 2014 and June 30, 2016. A patient experience questionnaire (PEQ) was given to each subject preoperatively and again at postoperative month one (POM1) and postoperative month 3 (POM3). Preoperative refraction and BCVA and postoperative refraction and BCVA for those who completed the PEQ and those who did not were compared using unpaired t-tests and proportions were compared using chi-square tests.
18,689 eyes of 10,206 patients were included in the study. A multifocal IOL was used in 84.3% of eyes and a monofocal IOL was used in 15.7% of eyes. 97.6% of the patients attended their POM1 visit and 87.4% attended their POM3 visit. 2738 patients (26.8%) completed the preoperative, POM1, and POM3 surveys. Patient-reported difficulty with glare, halo, starburst, ghosting, and night driving increased postoperatively but tended to improve by POM3. Compared to before surgery, patient-reported difficulty with distance and near activities decreased at both POM1 and POM3. Preoperatively, 5.3% and 8.2% of patients reported difficulty with distance and near activities, respectively, and at POM3 1.4% and 4.0% of patients reported difficulty. Those that completed the PEQ were more likely to be female, less myopic preoperatively, and had a better preoperative BCVA than those that did not compete the PEQ (P < 0.01 for all).
Patients who underwent refractive lens exchange reported worsening of glare, halo, starburst, ghosting, and night driving as of POM3 but improved functioning for distance and near activities. Although there was a difference in the gender distribution, preoperative myopic sphere, and preoperative BCVA in the patients that completed the PEQ compared to those that did not, the significance of these findings is unclear.
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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