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Nationwide Prospective Cohort Study on Cataract Surgery with Multifocal Intraocular Lens Implantation in Japan.

Abstract

PURPOSE

To conduct a nationwide prospective cohort study of multifocal intraocular lens (mfIOL) implantation to determine clinical outcomes and patient satisfaction and assess factors affecting patient satisfaction.

DESIGN

Prospective, multicenter cohort study.

METHODS

Setting: Institutional.

PATIENT POPULATION

A total of 1,051 consecutive patients (1,631 eyes) who underwent cataract surgery with mfIOL implantation at 65 Japanese institutions from January 2017 to June 2018. The inclusion criteria were patient age of 20 years and older and cataract surgery with mfIOL implantation. The exclusion criteria were the absence of informed consent, completed postoperative questionnaires, and no record of the IOL models implanted.

OBSERVATION PROCEDURES

The uncorrected and corrected distance visual acuities (UDVAs and CDVAs) at 5 meters; uncorrected VAs at 50, 40, and 30 centimeters; and questionnaires regarding subjective visual symptoms, spectacle independence, and surgical satisfaction were assessed 3 months postoperatively.

MAIN OUTCOME MEASURE

Odds ratios for the overall surgical satisfaction were computed for the preoperative/postoperative factors.

RESULTS

Data from 1,384 eyes of 871 patients were analyzed. The UDVAs and CDVAs, respectively, improved significantly at 3 months postoperatively. The intermediate and near VAs varied with the IOL models; 68.4% of patients were almost or totally spectacle-independent; 3.9% of patients reported surgical dissatisfaction. In patients implanted bilaterally with the same mfIOLs, postoperative blurred vision and/or decreased contrast was the most important factor in the overall surgical satisfaction.

CONCLUSIONS

MfIOLs provided good visual outcomes and high satisfaction rates in this large patient cohort. The difference in the outcomes with the extended depth-of-focus IOLs did not differ significantly from the bifocal IOLs. The postoperative blurred vision is important to the overall surgical satisfaction.

Authors+Show Affiliations

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. Electronic address: fwic7788@mb.infoweb.ne.jp.Hayashi Eye Hospital, Fukuoka, Japan.Visual Physiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.Sato Eye Clinic, Ibaraki, Japan.Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31377282

Citation

Negishi, Kazuno, et al. "Nationwide Prospective Cohort Study On Cataract Surgery With Multifocal Intraocular Lens Implantation in Japan." American Journal of Ophthalmology, 2019.
Negishi K, Hayashi K, Kamiya K, et al. Nationwide Prospective Cohort Study on Cataract Surgery with Multifocal Intraocular Lens Implantation in Japan. Am J Ophthalmol. 2019.
Negishi, K., Hayashi, K., Kamiya, K., Sato, M., & Bissen-Miyajima, H. (2019). Nationwide Prospective Cohort Study on Cataract Surgery with Multifocal Intraocular Lens Implantation in Japan. American Journal of Ophthalmology, doi:10.1016/j.ajo.2019.07.019.
Negishi K, et al. Nationwide Prospective Cohort Study On Cataract Surgery With Multifocal Intraocular Lens Implantation in Japan. Am J Ophthalmol. 2019 Aug 1; PubMed PMID: 31377282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nationwide Prospective Cohort Study on Cataract Surgery with Multifocal Intraocular Lens Implantation in Japan. AU - Negishi,Kazuno, AU - Hayashi,Ken, AU - Kamiya,Kazutaka, AU - Sato,Masaki, AU - Bissen-Miyajima,Hiroko, AU - ,, Y1 - 2019/08/01/ PY - 2019/04/16/received PY - 2019/07/21/revised PY - 2019/07/26/accepted PY - 2019/8/5/entrez PY - 2019/8/5/pubmed PY - 2019/8/5/medline JF - American journal of ophthalmology JO - Am. J. Ophthalmol. N2 - PURPOSE: To conduct a nationwide prospective cohort study of multifocal intraocular lens (mfIOL) implantation to determine clinical outcomes and patient satisfaction and assess factors affecting patient satisfaction. DESIGN: Prospective, multicenter cohort study. METHODS: Setting: Institutional. PATIENT POPULATION: A total of 1,051 consecutive patients (1,631 eyes) who underwent cataract surgery with mfIOL implantation at 65 Japanese institutions from January 2017 to June 2018. The inclusion criteria were patient age of 20 years and older and cataract surgery with mfIOL implantation. The exclusion criteria were the absence of informed consent, completed postoperative questionnaires, and no record of the IOL models implanted. OBSERVATION PROCEDURES: The uncorrected and corrected distance visual acuities (UDVAs and CDVAs) at 5 meters; uncorrected VAs at 50, 40, and 30 centimeters; and questionnaires regarding subjective visual symptoms, spectacle independence, and surgical satisfaction were assessed 3 months postoperatively. MAIN OUTCOME MEASURE: Odds ratios for the overall surgical satisfaction were computed for the preoperative/postoperative factors. RESULTS: Data from 1,384 eyes of 871 patients were analyzed. The UDVAs and CDVAs, respectively, improved significantly at 3 months postoperatively. The intermediate and near VAs varied with the IOL models; 68.4% of patients were almost or totally spectacle-independent; 3.9% of patients reported surgical dissatisfaction. In patients implanted bilaterally with the same mfIOLs, postoperative blurred vision and/or decreased contrast was the most important factor in the overall surgical satisfaction. CONCLUSIONS: MfIOLs provided good visual outcomes and high satisfaction rates in this large patient cohort. The difference in the outcomes with the extended depth-of-focus IOLs did not differ significantly from the bifocal IOLs. The postoperative blurred vision is important to the overall surgical satisfaction. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/31377282/Nationwide_Prospective_Cohort_Study_on_Cataract_Surgery_with_Multifocal_Intraocular_Lens_Implantation_in_Japan L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(19)30380-0 DB - PRIME DP - Unbound Medicine ER -