Visual Function and Change in Quality of Life After Bilateral Refractive Lens Exchange With the ReSTOR Multifocal Intraocular Lens

Abstract

To evaluate vision and quality of life and explore the correlation between vision and change of quality of life after bilateral refractive lens exchange of the Acrysof SA60D3 ReSTOR multifocal intraocular lens (IOL) for correction of ametropia in presbyopic populations. Pre- and postoperatively, the National Eye Institute Refractive Error Quality of Life Instrument (NEI-RQL) was self-administered by 30 consecutive refractive lens exchange patients, including 19 myopes and 11 hyperopes. The change of NEI-RQL scores was determined for each subscale covering a specific aspect of quality of life. Refraction, visual acuity, and contrast sensitivity function were evaluated 3 and 6 months postoperatively. Postoperatively, all patients achieved binocular uncorrected distance and near visual acuity of 20/30 or better. Photopic contrast sensitivity function decreased significantly at high spatial frequencies (P < .05). Overall scores of expectations, activity limitations, dependence on correction, appearance, and satisfaction were significantly higher postoperatively (P < .05). Greater improvement in near vision and dependence on correction was achieved in hyperopes. However, glare scores were significantly lower postoperatively (P < .001). Lower preoperative uncorrected near visual acuity was associated with higher scores for dependence on correction in myopes (r = 0.51, P = .027), and overall patient satisfaction correlated significantly with postoperative uncorrected distance visual acuity (r = -0.44, P = .015). Refractive lens exchange with the ReSTOR IOL in presbyopic patients provided good visual function and better patient satisfaction compared with preoperative corrections. Improvement in vision-related quality of life was most evident in hyperopes. A slight reduction in contrast sensitivity function appears to have no influence on quality of life.