Patient-Reported Outcomes/Satisfaction and Spectacle Independence with Blended or Bilateral Multifocal Intraocular Lenses in Cataract Surgery

Abstract

Purpose

To compare patient-reported outcomes (PROs) and satisfaction results after multifocal intraocular lens (IOL) implantation in three groups: two receiving bilateral implantation of the same IOL and another undergoing blended vision with two different multifocal IOLs.

Patients and methods

A questionnaire was administered to patients who had undergone uncomplicated cataract surgery and 2 months of follow-up: the first group underwent bilateral implantation with Alcon’s AcrySof ReSTOR 3.0 lens (“3.0/3.0,” n=78); the second group underwent implantation with the ReSTOR ActiveFocus 2.5 or the ReSTOR ActiveFocus 2.5 toric lens (“2.5 mini-monovision,” n=102); and the third group underwent implantation with the ReSTOR 2.5 lens in the dominant eye and the ReSTOR 3.0 lens in the non-dominant eye (“2.5/3.0,” n=89).

Results

Overall PROs and satisfaction was similar among the groups. Refractive outcomes and accuracy were similar among the groups, but the 2.5 mini-monovision group reported better intermediate vision. Refractive outcome differences were not meaningful among the groups and were not a differentiating factor in PROs. Substantially fewer patients in the 2.5 mini-monovision group noticed glare and halo compared with the 3.0/3.0 group (P<0.0001, chi-square test). No new safety concerns were reported.

Conclusion

The 2.5 mini-monovision results in a higher percentage of patients being satisfied with intermediate vision than bilateral ReSTOR 3.0 or blended vision with ReSTOR 2.5/3.0 implants, but overall PRO differences were not statistically significant.

Keywords:

• mini-monovision
• AcrySof ReSTOR
• cataract surgery
• spectacle independence
• glare
• multifocal intraocular lens

Acknowledgments

MDBackline LLC funded this study. Michelle Dalton, ELS, provided medical writing assistance; this assistance was funded by MDBackline, LLC.

Disclosure

This was an investigator-sponsored trial, supported by MDBackline, LLC, in collaboration with Alcon Laboratories. At the time of this study, all authors were in private practice; SSL is now the Chief Medical Officer at Alcon. At the time of this study, SSL and JAH were consultants to Alcon. JAH reports grants from Alcon, during the conduct of the study; personal fees from Alcon, outside the submitted work. MJ reports personal fees from Alcon, outside the submitted work. QA reports research support/funding from Alcon, during the conduct of the study. He is also the consultant and part of the Speaker’s Bureau for Alcon and Bausch & Lomb. The authors report no other conflicts of interest in this work.