Abstract
Purpose :
To describe the association between preoperative corneal higher order aberrations (HOAs) and visual and patient reported outcomes following cataract surgery with diffractive multifocal intraocular lenses.
Methods :
The electronic medical record of a large multi-center refractive surger practice was searched to identify patients who underwent bilateral cataract surgery with a diffractive multifocal intraocular lens between 1/1/2015 and 12/31/2016. The visual and patient reported outcomes were extracted, and matched with preoperative corneal HOAs extracted from the Pentacam (Wetzlar, Germany). Multivariable logistic regression analyses were conducted to identify HOAs that were associated with patient dissatisfaction following surgery as well as patient with moderate or severe photic pheonomena (glare, halos or starbursts) after surgery. Patients with a history of corneal refractive surgery or those who received different models of IOLs in each eye were excluded from the analysis. All patients who underwent placement of a multifocal lens underwent a thorough preoperative examination, and patients with corneal disease, severe dry eye, or grossly abnormal corneal topography were not offered multifocal lens placement.
Results :
A total of 382 patients were included. The median of the root mean square (RMS) of HOAs at a diameter of 4mm was 0.176 (interquartile range 0.138 to 0.228, range 0.055 to 1.22). A total of 90.3% of patients reported they were somewhat or very satisfied with their vision after surgery and 8% reported they were somewhat or very dissatisfied. A multivariable logistic regression analysis found no relationship between preoperative HOAs and patient-reported satisfaction at 3 months (OR 2.24, 95% CI -1.62 to 6.10, p = 0.256). There was no corrleation between preoperative HOAs and patient-reported moderate or severe glare, halo or starburst symptoms (p>0.08 for all comparisons).
Conclusions :
We found no association between preoperative HOAsand patient-reported satisfaction or photic phenomena at 3 months after surgery with a diffractive multifocal intraocular lens. The utility of analyzing HOAs in patients without overtly abnormal tophography in order to determine candidacy for diffractive multifocal lens placement may be limited.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.