Posters

Patient-reported outcomes (PROMs) in refractive lens exchange (RLE): factors in patient dissatisfaction

Poster Details

First Author: C.O'Donnell UK

Co Author(s):    I. Siso-Fuertes   A. Hartwig   S. Vaswani   J. Dermott   S. Rehman        

Abstract Details

Purpose:

To retrospectively analyse the possible causes of longer-term dissatisfaction amongst patients after RLE with bilateral implantation of a multifocal intraocular lens (IOL).

Setting:

Optegra Eye Hospitals, UK.

Methods:

A bespoke questionnaire with 25 questions addressing a range of areas including: use of spectacles, vision at various distances, photic phenomena, comfort/dry eye and reported complications was distributed up to 7 years after surgery to 2,427 patients who underwent RLE at a private eye hospital group in the UK. Patients were considered dissatisfied when they stated that they would probably/definitely choose not to have the surgery again or if they responded negatively to more than 10 questions. Statistical tests were used to check for associations between patient satisfaction and subjectively reported outcomes as well as objective and subjective clinical outcomes.

Results:

Using the agreed study criteria, 91% of respondents (N=840) were deemed to be satisfied overall. Statistically significant differences were found in the proportion of patients within the satisfied vs. dissatisfied group for most of the questionnaire items evaluated (p < 0.05).  However, no significant differences were found between the satisfied and dissatisfied patients when measured levels of postoperative distance or near visual acuity, axial length or pre- and postoperative spherical equivalent refraction were compared.

Conclusions:

The vast majority of patients undergoing RLE with multifocal IOLs was happy with the outcomes achieved in the longer postoperative period. Our results suggest that subjective photic phenomena (i.e. ghosting, glare, halos, starbust or dysphotopsia), reported spectacle dependence, subjective comfort at different distances and in different lightning conditions, and dry eye symptoms are more likely to be causes of dissatisfaction, irrespective of excellent measured visual and refractive predictability outcomes.

Financial Disclosure:

None