Quality of vision with monofocal intraocular lens after cataract surgery: Comprehensive evaluation and graphical illustration

Eur J Ophthalmol. 2024 Dec 20:11206721241306156. doi: 10.1177/11206721241306156. Online ahead of print.

Abstract

Purpose: To comprehensively characterize the quality of vision (QV) in an otherwise healthy population undergoing bilateral consecutive cataract surgery with the implantation of a monofocal intraocular lens (IOL) and to propose a graphical illustration.

Setting: Centro Hospitalar e Universitário de Coimbra, Portugal.

Design: Cross-sectional study.

Methods: This study included patients that underwent sequential bilateral cataract surgery with implantation of a monofocal acrylic foldable single-piece IOL. Patients were evaluated at the 3rd postoperative month in terms of bilateral uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) and corrected near visual acuity (CNVA); sphero-cylindrical refraction; bilateral reading speed and contrast sensitivity function (CSF); corneal topography/tomography; aberrometry; pupillometry; negative dysphotopsia (ND); Catquest-9SF and Quality of Vision (QoV) questionnaires.

Results: Both eyes from 26 (n = 26) consecutive patients with mean age of 68 years ± 6.68 were included. UDVA mean was logMAR = 0.01 ± 0.04, and CDVA was logMAR = 0.00 ± 0.04. The average reading speed was 110.42 words/minute. The CSF showed a descendent curve for higher spatial frequencies and was lower with glare. ND was present in 1.92% of the patients. Catquest-9SF mean was 95.46% and QoV mean score was 4.48 points. A radar graph showing median scores across the multiple variables assessed was produced demonstrating a wide panorama of QV.

Conclusion: Patients' satisfaction was correlated with CSF, reading speed, CNVA and residual spherical equivalent. To the author's best knowledge, this study establishes, for the first time, a comprehensive panorama of visual performance through a radar graph that can be utilized to describe the QV.

Keywords: Cataract extraction; intraocular lens; monofocal intraocular lens; quality of vision.