Predictors of Patient Satisfaction After Refractive Lens Exchange With an Extended Depth of Focus IOL.

Abstract

To identify independent factors associated with postoperative satisfaction after refractive lens exchange with an extended depth of focus intraocular lens (EDOF IOL). Patients who underwent a refractive lens exchange with bilateral implantation of the AT LARA 829MP IOL (Carl Zeiss Meditec, Jena, Germany) and attended the 3-month follow-up visit were included in the analysis (N = 351 patients). Demographics, preoperative and postoperative clinical parameters, and patient-reported outcomes were used in a regression model to determine predictors of 3-month postoperative satisfaction. The mean age of the study group was 58.2 ± 7.0 years (range: 45 to 79 years) and the mean preoperative sphere ranged between -12.50 and +6.75 diopters (D). At 3 months postoperatively, 86.6% of patients were very satisfied or satisfied with outcomes and 93.2% would recommend the procedure to their family or friends. Of all patients, 90.6% achieved binocular uncorrected distance visual acuity of 20/20 or better, 92.0% achieved binocular near vision of 20/50 or better, and 85.5% of eyes were within ±0.50 D of emmetropia. Logistic regression identified postoperative dry eye symptoms, binocular near and distance visual acuity, and glare symptoms as significant independent factors affecting patient satisfaction. Several factors were independently predictive of postoperative satisfaction after EDOF IOL implantation and addressing these may further improve patient satisfaction with the procedure, specifically, proper management of early symptoms of dry eye, ensuring good refractive predictability to maximize unaided vision, and counseling patients about the possibility of visual phenomena in the early postoperative period. [J Refract Surg. 2020;36(3):175-184.].