Comment on: Visual and patient-reported factors leading to satisfaction after implantation of diffractive EDoF and trifocal intraocular lenses.

Abstract

We read with great interest the article by Lwowski et al. entitled “Visual and patient-reported factors leading to satisfaction after implantation of diffractive EDoF and trifocal intraocular lenses.”1 We congratulate the authors for their efforts. This article gives us an insight into the various factors leading to satisfaction after implantation of premium intraocular lenses (IOLs). However, we wish to make certain observations. (1) In the article, it was indicated that there was no statistically significant difference between overall satisfaction when comparing refractive lens exchange (RLE) with cataract eyes. However, comparing satisfaction of patients who underwent RLE with that of cataract patients may not be justified since cataract patients experience better brightness after cataract removal. Moreover, RLE patients received more extended depth-of-focus (EDoF) IOLs and fewer trifocal IOLs, so the results may be skewed. (2) The authors reported that the Symfony IOL (Johnson & Johnson Vision) was implanted more often in male patients, which they believed was an accidental finding. We believe that this could be because men are more ardent night drivers in comparison with women, so EDoF IOL was the obvious choice of surgeon. However, women tend to be more critical in general, so this may skew the satisfaction rate since the ratio was not sex-matched. (3) The article stated that spherical equivalent played a major role in patient satisfaction. However, Table 3 summarized an insignificant difference in spherical equivalent between satisfied and unsatisfied patients (P = .252). (4) Moreover, similar satisfaction was reported between EDoF IOLs and trifocal or quadrifocal IOLs and very high satisfaction in the Panoptix group. However, it would have been easier for the readers if the results were presented in a tabular form. (5) Although the authors clearly stated that patients' occupations or hobbies were not taken into account, in our opinion this can greatly influence the satisfaction scores.