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Llovet-Rausell A, Ortega-Usobiaga J, Albarrán-Diego C, Beltrán-Sanz J, Bilbao-Calabuig R, Llovet-Osuna F. Visual Outcomes and Patient Satisfaction After Bilateral Refractive Lens Exchange With a Trifocal Intraocular Lens in 5,226 Patients With Presbyopia. J Refract Surg 2024; 40:e468-e479. [PMID: 39007809 DOI: 10.3928/1081597x-20240517-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
PURPOSE To assess visual and refractive outcomes and visual function after bilateral RayOne Trifocal toric and nontoric intraocular lens (IOL) (Rayner) implantation in patients with presbyopia. METHODS Charts of patients with presbyopia who underwent refractive lens exchange with bilateral implantation of the RayOne Trifocal IOL (toric and non-toric) were retrospectively reviewed. Visual and refractive outcomes were evaluated at 3 months. Patient satisfaction, spectacle independence, and visual disturbance profile were assessed by questionnaires. RESULTS A total of 5,226 patients were assigned to one of two groups: 1,010 patients had toric IOL implantation (toric group) and 4,216 patients received the non-toric model (non-toric group). Mean ± standard deviation visual acuity at 3 months for the toric group was binocular uncorrected distance visual acuity (UDVA) of 0.07 ± 0.11 logMAR, monocular corrected distance visual acuity (CDVA) of 0.05 ± 0.07 logMAR, binocular uncorrected near visual acuity (UNVA) at 40 cm of 0.10 ± 0.09 logMAR, binocular uncorrected intermediate visual acuity (UIVA) at 40 cm of 0.13 ± 0.12 logMAR, postoperative spherical equivalent (SE) of -0.21 ± 0.47 diopters (D), and cylinder of -0.34 ± 0.40 D. The non-toric group had binocular UDVA of 0.04 ± 0.08 logMAR, monocular CDVA of 0.05 ± 0.07 logMAR, binocular UNVA of 0.10 ± 0.08 logMAR, binocular UIVA of 0.13 ± 0.11 logMAR, SE of -0.08 ± 0.38 D, and cylinder of -0.28 ± 0.34 D. No statistically significant differences were found in achieving spectacle independence and there were high levels of satisfaction in both groups. CONCLUSIONS In this retrospective analysis with more than 5,000 patients, both the toric and non-toric RayOne Trifocal IOL models provided good visual performance at all distances, resulting in excellent levels of spectacle independence and patient satisfaction. [J Refract Surg. 2024;40(7):e468-e479.].
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Li Z, Zhang R, Wu X, Zhu Z, Meng Z, Yang X, Wang D, Zhao Y. Analysis of the Dysfunctional Lens Index as a Novel Criterion for Surgical Decision-Making in Age-Related Cataracts. Semin Ophthalmol 2023; 38:617-624. [PMID: 36788652 DOI: 10.1080/08820538.2023.2176241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/06/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND The dysfunctional lens index (DLI) provided by a ray-tracing aberrometry system is an objective index in cataract assessment. The purpose of this study is to evaluate correlations among Lens Opacities Classification System III (LOCS III) grades, Catquest 9SF scores, and the (DLI) and the DLI's role in surgical decision-making in age-related mixed cataract. METHODS This trial was registered at NIH (clinicaltrial.gov) on January 5, 2021 (NCT04711395). In this prospective cross-sectional study, age-related mixed cataract patients were recruited. One high-volume and two low-volume surgeons made surgical decisions based on corrected distance visual acuity (CDVA), LOCS III graded photographs, and Catquest 9SF scores. Their decision-making agreement was evaluated with Cohen's kappa coefficient. Correlations among the parameters were analyzed. The optimal cut-off DLI was calculated using a receiver operating characteristic curve. RESULTS Overall, 106 patients (106 eyes) were included. Very good agreement levels were noted among the high- and low-volume surgeons (Cohen's kappa coefficient, 0.848) (95% CI, 0.748-0.948). The DLI had the strongest correlation with Catquest 9SF scores (R2 = 0.566), followed by with posterior subcapsular (R2 = 0.418), nuclear opalescence (R2 = 0.388), and cortical (R2 = 0.333, all P < .0001) cataract LOCS III grades. Catquest 9SF scores were correlated with cortical (R2 = 0.249), nuclear opalescence (R2 = 0.278), and posterior subcapsular (R2 = 0.235, all P < .0001) cataract LOCS III grades. A cut-off DLI of 5.36 was identified as a surgical criterion (specificity, 86.9%; sensitivity, 93.3%). CONCLUSIONS The DLI is valuable for objectively assessing patient complaints and lens opacity severity. LOCS III remains effective and economical in assessing early cortical cataracts with relatively clear central lenses. A cut-off DLI ≤5.36 could be a criterion for preoperative decision-making.
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Affiliation(s)
- Zhangliang Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Rui Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Xueer Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Zehui Zhu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Ziqi Meng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Xing Yang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Dandan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
| | - Yune Zhao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Wenzhou, China
- Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China
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Kabanovski A, Shah B, D’Silva C, Ma J, Minotti SC, Qian J, Hatch W, Reid R, Chaudhary V, El-Defrawy S, Ahmed II, Schlenker MB. Multi-center validation of Catquest-9SF visual function questionnaire in Ontario, Canada. PLoS One 2023; 18:e0278863. [PMID: 37410799 PMCID: PMC10325044 DOI: 10.1371/journal.pone.0278863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/25/2022] [Indexed: 07/08/2023] Open
Abstract
PURPOSE To investigate the psychometric performance and responsiveness of Catquest-9SF, a patient-reported questionnaire developed to evaluate visual function as related to daily tasks, in patients referred for cataract surgery in Ontario, Canada. METHODS This is a pooled analysis on prospective data collected for previous projects. Subjects were recruited from three tertiary care centers in Peel region, Hamilton, and Toronto, Ontario, Canada. Catquest-9SF was administered pre-operative and post-operatively to patients with cataract. Psychometric properties, including category threshold order, infit/outfit, precision, unidimensionality, targeting, and differential item functioning were tested using Rasch analysis with Winsteps software (v.4.4.4) for Catquest-9SF. Responsiveness of questionnaire scores to cataract surgery was assessed. RESULTS 934 patients (mean age = 71.6, 492[52.7%] female) completed the pre- and post-operative Catquest-9SF questionnaire. Catquest-9SF had ordered response thresholds, adequate precision (person separation index = 2.01, person reliability = 0.80), and confirmed unidimensionality. The infit range was 0.75-1.29 and the outfit range was 0.74-1.51, with one item ('satisfaction with vision') misfitting (outfit value = 1.51). There was mistargeting of -1.07 in pre-operative scores and mistargeting of -2.43 in both pre- and post-operative scores, meaning that tasks were relatively easy for respondent ability. There was no adverse differential item functioning. There was a mean 1.47 logit improvement in Catquest-9SF scores after cataract surgery (p<0.001). CONCLUSION Catquest-9SF is a psychometrically robust questionnaire for assessment of visual function in patients with cataract in Ontario, Canada. It is also responsive to clinical improvement after cataract surgery.
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Affiliation(s)
- Anna Kabanovski
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Bindra Shah
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Chelsea D’Silva
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Julia Ma
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Simona C. Minotti
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Jenny Qian
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Wendy Hatch
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Robert Reid
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Varun Chaudhary
- Department of Eye Medicine and Surgery, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Sherif El-Defrawy
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Iqbal Ike Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Matthew B. Schlenker
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
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Wei D, Wei L, Yanjun H, Zequan X, Lei J, Qiang W. Visual quality analysis using the Chinese Catquest-9SF scale following different spherical aberration IOL implantation. Front Public Health 2022; 10:1029002. [PMID: 36407986 PMCID: PMC9670146 DOI: 10.3389/fpubh.2022.1029002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Based on the Chinese version of the Catquest-9SF scale, the contrast sensitivity meter and wavefront aberrometer were used to evaluate the visual quality of cataract patients implanted with different spherical aberrations IOL. Design Retrospective Observational Study. Methods Patients who had the lens implantation in our department from January 2020 to December 2021 were enrolled. All patients underwent uncorrected visual acuity, best corrected visual acuity and slit lamp microscope, high-order aberrations and contrast sensitivity test. The KR-1W wavefront analyzer (Topcon Medical System, Tokyo, Japan) was used to measure wavefront aberrations post-operation. The Chinese Catquest-9SF scale was used to score the postoperative visual satisfaction of the patients. Results 145 patients were screened according to the exclusion criteria, including 51 patients in the zero aspherical IOL (SOFTEC HD) group, 42 patients in the negative aspherical IOL (ZCB00) group, and a total of 52 patients in the spherical IOL (HQ-201HEP) group. The score was the highest in the zero spherical aberration group, followed by the negative spherical aberration group with the lowest scores in the spherical IOL group. Higher-order aberrations are relatively low in eyes implanted with the zero spherical aberration group. Contrast sensitivity with spherical lenses under glare-free and glare conditions was lower than those with aspheric lenses, and at higher frequencies the zero-aberration aspheric lens performed the best. Conclusion The Chinese Catquest-9SF scale provides an indication of visual quality after aspheric IOL implantation.
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Affiliation(s)
- Du Wei
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China,Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou, China
| | - Lou Wei
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Yanjun
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Zequan
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jin Lei
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou, China
| | - Wu Qiang
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Wu Qiang
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Seth I, Bulloch G, Thornell E, Lundström M, Agarwal S. Catquest-9SF questionnaire shows greater visual functioning in bilateral cataract populations: A prospective study. Indian J Ophthalmol 2022; 70:3820-3826. [PMID: 36308103 PMCID: PMC9907286 DOI: 10.4103/ijo.ijo_736_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Visual functioning evaluated by the Catquest-9SF questionnaire has shown to be a valid measure for assessing a patient's prioritization for cataract surgery. This study adapted Catquest-9SF for visual function outcomes post uni-lateral cataract surgery or bi-lateral cataract surgery. Methods Visual functioning was assessed before and after uni-lateral or bi-lateral cataract surgery using the Catquest-9SF questionnaire. Patients were enrolled to this study prior to their cataract surgery between March 29 and April 30, 2021 at Shellharbour Hospital, Australia. Catquest-9SF questionnaires were completed prior to and 3 months post surgery. Resulting data were assessed for fit to a Rasch model using WINSTEPS software (version 4.2.0). Catquest-9SF data analysis of Chi-square, Wilcoxon sum test, and Fischer's test were performed in R (version 4.1.0). P value <.05 was considered statistically significant. Results Sixty-one patients (mean age = 73.2 years, 62% female) were included for analysis. Catquest-9SF response thresholds, adequate precision (person separation index = 2.58, person reliability = 0.87, Cronbach's alpha = 0.74), uni-dimensionality, and no misfits (infit range 0.65-1.33; outfit range 0.64-1.31) were recorded. The mean of item calibration for patients was -0.22 post-operatively. There was significant (P <.05) improvement (16.3%) in visual functions across all nine Catquest 9-SF items. There was a significant mean visual function difference between patients with uni-lateral (10.1%) and bi-lateral cataract surgery (22.3%) pre-operatively and post-operatively. Conclusion The Catquest-9SF questionnaire showed excellent psychometric properties and can assess visual functioning in an Australian population. There was a significant improvement in patient visual function post cataract surgery and higher functioning with bi-lateral cataract surgery.
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Affiliation(s)
- Ishith Seth
- Department of Medicine and Surgery, Central Clinical School, Monash University, Melbourne, Australia,Correspondence to: Dr. Ishith Seth, Department of Medicine and Surgery, Central Clinical School, Monash University, Melbourne, 3004, Australia. E-mail:
| | | | - Erin Thornell
- Illawarra Shoalhaven Local Health District, Australia
| | - Mats Lundström
- Department of Clinical Sciences, Ophthalmology, Lund University, Lund, Sweden
| | - Smita Agarwal
- Illawarra Shoalhaven Local Health District, Australia
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Hui N, Chu MF, Li Y, Wang CY, Yu L, Ma B. Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens. Int J Ophthalmol 2022; 15:1460-1467. [PMID: 36124189 DOI: 10.18240/ijo.2022.09.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens (IOL) and asymmetric refractive multifocal IOL. METHODS The prospective nonrandom, comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs: AT LISA tri 839MP (30 eyes; Carl Zeiss Meditec, Germany) and LS-313 MF30 (30 eyes; Oculentis GmbH, Germany). Visual acuity, refractive outcome, contrast sensitivity, defocus curves, quality of vision, and optical phenomena were evaluated at 3mo postoperatively. RESULTS There were no statistical differences between groups in uncorrected distance visual acuity (P=0.13) and uncorrected near visual acuity (P=0.54). In contrast, uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group (P=0.02). No significant statistical between-group difference was detected in cylinder (P=0.43). Compared to trifocal group, spherical refraction and spherical equivalent in refractive multi focal group were more myopic (P<0.01). Under photopic conditions, no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree (cpd). The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group (P=0.01, P=0.034, respectively). The questionnaires of quality of vision and optical phenomena showed no differences between groups. CONCLUSION Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity. Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.
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Affiliation(s)
- Na Hui
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Mei-Fang Chu
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Yan Li
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Cong-Yi Wang
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Lei Yu
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Bo Ma
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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