Development of a New Subjective Questionnaire: The Freedom from Glasses Value Scale (FGVS)

Abstract

To develop a patient self-administered questionnaire assessing the added value of complete independence from spectacles (hereafter referred to as glasses) after multifocal intraocular lens (IOL) surgery. Exploratory interviews with five cataract patients and six presbyopic patients with AcrySof ReSTOR IOLs (Alcon Laboratories Inc) implanted in both eyes for at least 6 months were conducted. The questionnaire's conceptual framework was developed after interview analysis. Based on the identified concepts, items were generated simultaneously in French and Spanish using patients' own words, and comprehension tested with six French patients; the Spanish questionnaire underwent clinician review and was further tested with four Spanish patients. French and Spanish versions were accordingly refined. The questionnaire was linguistically validated in UK English and Danish. Interview analysis resulted in the identification of 9 global concepts: global vision, practical constraints related to wearing glasses, impact of eye surgery on the patient's life, improvement of practical issues without glasses, improvement of psychological constraints without glasses, physical appearance/aesthetic aspect, self-image and in the eyes of others, eyesight problems left behind after surgery, and recommendation of surgery to others. The initial version of the test questionnaire contained 23 items; 2 items were deleted and changes were made after clinician review and patient testing. The final questionnaire named Freedom from Glasses Value Scale (FGVS) contained 21 items and four general additional questions. Beyond functional aspects, this qualitative study identified additional benefits in cataract and presbyopic patients living free of glasses after receiving multifocal IOLs. The FGVS now needs to be psychometrically validated (eg, construct validity and reliability).