A comparison of patient-reported outcomes from an apodized diffractive intraocular lens and a conventional monofocal intraocular lens

ABSTRACT

Objective: The primary objective of this research was to compare cataract patient-reported outcomes of subjects bilaterally implanted with apodized diffractive intraocular lenses (AD-IOL) to subjects bilaterally implanted with conventional monofocal intraocular lenses (CM-IOL). A secondary objective was to establish the relationship between uncorrected visual acuity and patient-reported outcomes.

Methods: This was a prospective non-randomized, open-label clinical trial consisting of 339 patients bilaterally implanted with the AD‐IOL and 156 bilaterally implanted with the CM‐IOL. The outcomes of both groups were assessed 6 months postoperatively after second eye implantation. Assessed endpoints included patient-reported outcomes and visual acuity. Limitations of this study include the lack of random assignment to treatment groups and lack of masking of both the physicians and patients.

Results: AD‐IOL patients demonstrated significantly better uncorrected near visual acuity (UCNVA) compared to CM‐IOL patients (0.02 versus 0.41 log MAR [logarithm of the minimum angle of resolution], respectively; p < 0.0001). UCNVA was significantly correlated with nine patient-reported outcomes in the AD‐IOL group and two patient-reported outcomes in the CM‐IOL group. Significantly more AD‐IOL patients reported spectacle independence compared to CM patients (80% versus 8% respectively; p < 0.0001). AD‐IOL patients reported their vision quality as better than CM‐IOL patients ( p < 0.0001). AD‐IOL patients were more satisfied with their daytime ( p < 0.0001), nighttime ( p = 0.0013), and overall ( p < 0.0001) vision than CM‐IOL patients. AD‐IOL patients reported less trouble with their daytime ( p < 0.0001) and nighttime ( p = 0.0238) vision compared to CM‐IOL patients. Furthermore, AD‐IOL patients reported less distance vision limitation ( p = 0.0282), less near vision limitation ( p < 0.0001), and less social limitation ( p < 0.0001) than CM‐IOL patients.

Conclusions: The patient reported near vision benefits of the AD‐IOL coupled with its high rate of spectacle independence significantly improved cataract patients’ health-related quality-of-life, compared to a CM‐IOL.

Key words: :

• Eyeglasses utilization
• Health status indicators
• Intraocular
• Lens implantation
• Patient satisfaction
• Treatment outcome
• Visual acuity