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Survey: patient satisfaction improves with monofocal/multifocal lenses


San Francisco-Results of a small study suggest that well-selected patients can be highly satisfied with their vision when having the multifocal AcrySof ReSTOR IOL (Alcon Laboratories) implanted in one eye and a monofocal lens in the other, said Richard Tipperman, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Dr. Tipperman conducted a mail survey of 10 patients who had a monofocal IOL placed when they underwent their first eye surgery and chose to have the ReSTOR lens placed when their second eye was operated on. Nine of the 10 had the first eye surgery before the ReSTOR lens was available, all were unhappy with their absolute presbyopia, and after thorough counseling, were willing to undergo ReSTOR IOL implantation in the second eye.

In the survey instrument, patients were posed a series of statements about comfort with various vision tasks and asked to mark a line from 1 to 10 (1 = strongly disagree, 10 = strongly agree) at the place that most closely described their feelings or thoughts. The results revealed high satisfaction with the majority of patients indicating being very comfortable with their vision across the entire functional range.

The patients in the population included six women and four men, and their average age was close to 60 years.

Satisfaction with reading

When posed with the statement, "I am able to read comfortably most of the time," nine patients at least agreed (scores 6 to 10), including four who strongly agreed (10), while the 10th strongly disagreed. The responses were generally similar when patients were asked about ability to read comfortably without glasses most of the time.

With respect to driving comfort, eight patients strongly agreed they could drive comfortably most of the time and the other two patients were in relatively strong agreement (8). The results were the same when patients responded to a statement about comfort driving without glasses.

"Overall, it seems these patients were very happy with their distance function," Dr. Tipperman said.

The next two statements related to watching television (TV). Nine patients strongly agreed that they were able to watch TV comfortably most of the time and the 10th patient was also in agreement (7). The results were identical when the statement asked about watching TV comfortably without glasses.

Questions about computer use indicated somewhat less comfort. However, in no case did any patient strongly disagree with statements about ability to use a computer comfortably most of the time or comfortably without glasses most of the time.

"The results indicate the majority of patients are still very comfortable with their vision at the computer and are able to function without their glasses most of the time," Dr. Tipperman said. "Keep in mind that with a monofocal IOL in one eye and the ReSTOR lens in the other, these patients are overall very distance dominant, which explains their generally high ratings for vision function when driving or watching TV."

All patients strongly disagreed with the statement that they sometimes had to close one eye to perform distance vision tasks. Nine strongly disagreed with the statement that they sometimes had to close one eye to perform near vision tasks, while the 10th indicated it was necessary from time to time.

"These responses are further demonstration that this optical system of a monofocal IOL in one eye and the ReSTOR lens in the fellow eye is strongly distance-dominant," Dr. Tipperman explained.

As a bottom line, the responses of nine of the 10 patients indicated high agreement (ratings of 9 or 10) with the statement, "Overall I am satisfied with the results of my ReSTOR lens."

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