This article is more than 5 years old. Information may no longer be current.
Patient satisfaction with multifocal IOLs linked to personality traits
Click Here to Manage Email Alerts
Personality traits influenced perception of visual disturbances and patient satisfaction after implantation of multifocal IOLs, according to a study.
The study included 183 patients who underwent bilateral multifocal IOL implantation.
A questionnaire was used preoperatively to evaluate personality traits such as conscientiousness, orderliness, dutifulness, achievement striving, deliberation, self-discipline and competence.
Another questionnaire was administered at 3 months and 6 months postoperatively to gauge overall satisfaction, spectacle dependence, visual function and ease of performing daily functions.
Uncorrected and corrected near and distance visual acuities were assessed preoperatively and 3 months and 6 months postoperatively.
Halos were described as slight by 18.4% of patients, moderate by 25% and severe by 12.8% at 3 months. No patients reported severe glare.
Photic phenomena did not trouble 75.4% of patients; 24.6% were troubled, but patients were able to tolerate those phenomena.
Additionally, at 3 months, 82.2% of patients said they would choose a multifocal IOL again, 3.7% would not and 14.1% were undecided; the percentages were nearly identical at 6 months.
Twenty-three patients were dissatisfied with postoperative outcomes. Eleven of those 23 patients were spectacle-free, and seven had near and distance visual acuity exceeding 0.1 logMAR and less than 1 D of astigmatism.
“These seven patients lay outside the normal range for at least two or more of the compulsive checking, orderliness, competence and dutifulness personality traits. No specific postoperative parameter could explain their dissatisfaction,” the authors said.
Disclosure: The authors have no relevant financial disclosures.
Perspective
Back to Top
Scott M. MacRae, MD
What makes for a happy multifocal patient? One prerequisite to patient satisfaction I like to call the “CAT scan”: a clear capsule, minimal ametropia and a healthy tear film. Posterior capsule opacification, defocus/astigmatism and dry eye are the leading causes of multifocal patient dissatisfaction, and they are treatable. But what happens when all postoperative parameters are normal, as noted in 4% of patients in this study?
The authors addressed this challenging question. They noted that perceived blurred vision, halo and glare were also deterrents to patient satisfaction. More importantly, personality characteristics including compulsive checking, orderliness, competence and dutifulness were correlated to greater glare and halo subjective disturbance.
Clinicians have intuitively learned to steer clear of using multifocals in compulsive, high-strung individuals, but defining exactly who fits into this category is challenging. The authors designed a 15-minute questionnaire that asked about opinions on spectacle independence and side effects and two personality inventory tests, and thankfully they plan on designing a condensed questionnaire. A validated “happy patient” questionnaire would be valuable based on their findings.
Preoperatively, patients would also be well-served by a visual simulation of mild, moderate and severe glare, halos and blurred vision, which would alert the patient to the trade-offs of multifocals. This study helps us better identify potential happy multifocal patients.
Click Here to Manage Email Alerts