Multivariate Regression Analysis Identifying Predictors of Patient Satisfaction with Multifocal IOLs: +4.00/+4.00 vs +3.25/+3.25 vs +3.25/EDOF

Figures & data

Box 1 Preoperative Clinical Metrics

Age

Eye Dominance

Mesopic Pupil Size

Photopic Pupil Size

Spherical Equivalent

Angle Kappa

RMS Factor

Trefoil

Coma

Spherical Aberration

Box 2 Postoperative Clinical Metrics

UDVA (Snellen)

Spherical Equivalent

Astigmatism

Best Corrected Distance VA

UNVA Letters Read at Patient’s Preferred Focal Distance

Patient’s Preferred Focal Distance for UNVA (cm)

UIVA Letters Read at Fixed Focal Distance (63cm)

UIVA Letters Read at Patient’s Preferred Focal Distance

Patient’s Preferred Focal Distance UVIA (cm)

Reading Acuity (logMAR)

Patient’s Preferred Focal Distance for Reading Acuity (cm)

Reading Speed (WPM)

Patient’s Preferred Focal Distance for Reading Speed (cm)

Questionnaire: Overall Satisfaction

Questionnaire: Glasses use for Distance

Questionnaire: Glasses use for Near

Questionnaire: Glasses use for Intermediate

Questionnaire: Ability to perform Near (fine print)

Questionnaire: Ability to perform Near (moderate print)

Questionnaire: Ability to perform Intermediate (computer)

Questionnaire: Ability to perform Distance

Table 1 Patient Satisfaction Survey

1. In general, how satisfied have you been with your OVERALL VISUAL FUNCTION without glasses?
Please check one:	☐ Very Satisfied	☐ Satisfied
☐ No Difference	☐ Dissatisfied	☐ Very dissatisfied
2. In general, how often each day do you use glasses for DISTANCE VISION? (TV, driving, etc.)
Please check one:	☐ None of the time	☐ Some of the time
☐ Half of the time	☐ Most of the time	☐ All of the time
3. In general, how often each day do you use glasses for NEAR VISION? (reading a book or newspaper)
Please check one:	☐ None of the time	☐ Some of the time
☐ Half of the time	☐ Most of the time	☐ All of the time
4. In general, how often each day do you use glasses for INTERMEDIATE VISION? (arms length activity, like the computer)
Please check one:	☐ None of the time	☐ Some of the time
☐ Half of the time	☐ Most of the time	☐ All of the time
5. Please rate your ability to perform the following activities without glasses:
Reading small print (phonebook or drug package insert):	☐ Excellent	☐ Very Good
☐ Good	☐ Fair	☐ Poor
6. Please rate your ability to perform the following activities without glasses:
Reading the newspaper:	☐ Excellent	☐ Very Good
☐ Good	☐ Fair	☐ Poor
7. Please rate your ability to perform the following activities without glasses:
Working on a computer (arms length activity):	☐ Excellent	☐ Very Good
☐ Good	☐ Fair	☐ Poor
8. Please rate your ability to perform the following activities without glasses:
Seeing objects far away:	☐ Excellent	☐ Very Good
☐ Good	☐ Fair	☐ Poor
9. If given the opportunity, would you again choose to pay out of pocket to have surgery with multifocal implants, which allow you to read without glasses, or would you elect to pay less money and receive the implants that do not allow you to read without glasses?
☐ I would still elect to receive the same multifocal implants
☐ I would accept implants that do not enable me to read without glasses

Table 2 Demographic Characteristics

Parameter	+4.00/+4.00 (n=55)	+3.25/+3.25 (n=66)	+3.25/EDOF (n=55)
Age
Mean ± SD  Min, Max	65.15 ± 8.79 42, 82	66.14 ± 9.11 45, 86	61.69 ± 7.77 44, 81
Sex, n (%)
Male  Female	27 (49%) 28 (51%)	27 (41%) 39 (59%)	12 (22%) 43 (78%)

Table 3 Results of Subjective Patient Questionnaire

Parameter	Mean ± SD			P value
	+4.00/+4.00	+3.25/+3.25	+3.25/EDOF	+4.00/+4.00 vs +3.25/+3.25	+4.00/+4.00 vs +3.25/EDOF	+3.25/+3.25 vs +3.25/EDOF
Overall Satisfaction (visual function without glasses)^a	1.63 ± 0.487	1.82 ± 0.462	1.80 ± 0.404	0.0307*	0.0504*	0.8040
Frequency of glasses use – Distance^b	1.98 ± 0.136	1.98 ± 0.123	1.98 ± 0.135	1.00	0.4931	0.4485
Frequency of glasses use - Near	1.94 ± 0.231	1.92 ± 0.404	1.76 ± 0.576	0.7473	<0.0001*	<0.0001*
Frequency of glasses use - Intermediate	1.87 ± 0.584	1.83 ± 0.597	1.96 ± 0.189	0.7130	0.2610	0.1137
Ability to read small print (phonebook) without glasses †	4.20 ± 0.73663	4.00 ± 0.96775	3.82 ± 1.07309	0.1461	0.0232*	0.057
Ability to read newspaper without glasses	4.444 ± 0.6914	4.439 ± 0.7260	4.42 ± 0.7895	0.9695	0.7961	0.8178
Ability to work on computer without glasses	3.91 ± 1.0947	4.32 ± 0.8949	4.65 ± 0.5517	0.02*	0.0001*	0.002*
Ability to see far away without glasses	4.44 ± 0.69137	4.53 ± 0.78876	4.76 ± 0.46997	0.5125	0.006*	0.047*

Notes: ^aOverall satisfaction scale: +2 Very Satisfied, +1 Satisfied, 0 No Difference, −1 Dissatisfied, −2 Very dissatisfied. ^bFrequency scale: +2 None of the time, +1 Some of the time, 0 Half of the time, −1 Most of the time, −2 All of the time. ^†Ability scale: 5 Excellent, 4 Very Good, 3 Good, 2 Fair, 1 Poor. *Statistical significance defined as p<0.05.

Figure 1 +4.00/+4.00 Multivariate Regression.

Figure 2 +4.00/+4.00 Multivariate Regression.

Figure 3 +3.25/+3.25 Multiple Regression Analysis.

Figure 4 EDOF/+3.25 Multiple Regression Analysis.

Figure 5 EDOF/+3.25 vs +3.25/+3.25 vs +4.00/+4.00.

Notes: ^†Scores: +2 None of the time; +1 Some of the time; 0 Half of the time; −1 Most of the time; −2 All of the time. *Significantly in favor of +3.25/+3.25 vs +3.25/EDOF. ^§Significantly in favor of +4.00/+4.00 vs +3.25/EDOF.

Figure 6 EDOF/+3.25 vs +3.25/+3.25 vs +4.00/+4.00.

Notes: ^†Scores: 5 Excellent; 4 Very Good; 3 Good; 2 Fair; 1 Poor. *Significantly in favor of EDOF/+3.25 vs +3.25/+3.25. ^§Significantly in favor of EDOF/+3.25 vs +4.00/+4.00.

Figure 7 EDOF/+3.25 vs +3.25/+3.25 vs +4.00/+4.00.

Notes: *EDOF/+3.25 significantly better vs +3.25/+3.25 and +4.00/+4.00.

Table 4 Comparison of Outcomes Between Cohorts

Parameter	Mean ± SD			P value
	+4.00/+4.00	+3.25/+3.25	+3.25/EDOF	+4.00/+4.00 vs +3.25/+3.25	+4.00/+4.00 vs +3.25/EDOF	+3.25/+3.25 vs +3.25/EDOF
PreOp Mesopic Pupil (mm) OU	4.854 ± 0.93459	4.839 ± 0.85949	5.046 ± 0.97627	0.9281	0.2985	0.2351
PreOP Photopic Pupil (mm) OU	3.429 ± 0.68745	3.503 ± 0.70339	3.632 ± 0.79048	0.5714	0.1757	0.1719
PreOP Spherical Equivalent OU	−1.36 ± 3.62985	−0.77 ± 3.03661	−1.39 ± 3.53444	0.3294	0.9167	0.0396*
PostOp UDVA (Snellen) OU	20/22 ± 2.981	20/20.76 ± 1.806	20/20 ± 1.667	0.0057*	<0.001*	0.0197*
PostOp Spherical Equivalent OU	0.025 ± 0.27692	−0.036 ± 0.21891	−0.027 ± 0.23821	0.8042	0.2887	0.8411
PostOp Astigmatism OU	0.3455 ± 0.22944	0.4413 ± 0.22168	0.2955 ± 0.25295	0.0215*	0.3363	0.0015*
PostOp BDVA (Snellen) OU	20/20.18 ± 0.945	20/20.08 ± 0.615	20/18.91 ± 2.344	0.4851	0.0006*	0.0004*
PostOp UNVA Letters Read OU	98.56 ± 4.936	97.80 ± 4.655	98.78 ± 3.606	0.3860	0.9042	0.2686
PostOp UNVA Patients Best Distance (cm) OU	38.04 ± 3.41	38.26 ± 5.37	40.48 ± 4.73	0.7932	0.0031*	0.0219*
PostOp UIVA at Fixed Distance 63cm Letters Read OU	90.20 ± 6.32	97.21 ± 4.32	99.69 ± 3.54	<0.0001*	<0.0001*	0.0012*
PostOp UIVA Patients Best Distance Letters Read OU	94.58 ± 6.620	101.77 ± 5.414	103.46 ± 3.66	<0.0001*	<0.0001*	0.0427*
PostOp UIVA Patients Best Distance (cm) OU	59.74 ± 2.654	54.38 ± 7.402	54.63 ± 7.58	<0.0001*	<0.0001*	0.9480
PostOp Reading Acuity (LogMAR) OU	0.004364 ± 0.08796	−0.04136 ± 0.08572	−0.05491 ± 0.09418	0.0212*	0.0014*	0.5007
PostOp Reading Acuity Patients Best Distance (cm)	39.20 ± 2.0763	39.97 ± 5.3117	41.95 ± 3.8558	0.3136	<0.0001*	0.0313*
PostOp Reading Speed OU (WPM)	82.34 ± 37.278	78.09 ± 46.935	75.91 ± 22.053	0.5995	0.2765	0.7435
PostOp Reading Speed Patients Best Distance (cm) OU	39.28 ± 2.12891	40.21 ± 5.28427	41.64 ± 3.48735	0.2431	0.0001*	0.0563
Angle Kappa OU	0.2868 ± 0.1156	0.2941 ± 0.1264	0.2880 ± 0.1249	0.7628	0.9838	0.7449
RMS Factor OU	0.6051 ± 0.24965	0.5478 ± 0.19341	0.6129 ± 0.29325	0.1912	0.8207	0.1488
Trefoil OU	0.1777 ± 0.0935	0.1462 ± 0.0757	0.1735 ± 0.1189	0.0607	0.9222	0.1291
Coma OU	0.1396 ± 0.0744	0.1166 ± 0.0571	0.1492 ± 0.0926	0.0782	0.5038	0.0227*
Spherical Aberrations OU	−0.0003 ± 0.04502	−0.0062 ± 0.05223	0.0216 ± 0.06948	0.5410	0.0586	0.0187*

Note: *Statistical significance defined as p<0.05.

Figure 8 TECNIS^® Multifocal 1-Piece Defocus Curve.