The majority of cataract patients will be diagnosed by an optometrist with whom they have a long-standing relationship. This is highlighted by statistics that show that cataract surgery is the most frequently performed surgery in the United States, with some estimates stating that by 2020 more than 30 million Americans will have at least one cataract.
Amazing technological advances in intraocular lenses (IOLs) have transformed cataract surgery into a refractive procedure, with the ability to provide good vision at all distances. Very few patients, however, are choosing these options.2 Optometrists are in an ideal position to educate patients about their surgical options and help them determine the best IOLs for their lifestyle.
Gauging satisfaction with IOLs
This single-center, open-label, retrospective and prospective study compared 100 eyes that received either the one- or three-piece Tecnis Multifocal IOL, 57 eyes that received the ReSTOR lens, and 50 eyes that received the Crystalens IOL (a total of 207 eyes). All patients were 21 years of age or older and received a presbyopia correcting lens in one or both eyes without surgical complications or adverse events.
Outcome measures included manifest refraction, uncorrected visual acuity, and best-corrected visual acuity under photopic light conditions at least 3 months postoperatively. Their visual acuities were assessed at far distance using Snellen acuity, and at intermediate and near distances using ETDRS. Patients also received a questionnaire assessing their level of satisfaction with their vision.
Results showed that patients bilaterally implanted with the Tecnis IOL had a superior performance at near distances, with 92% having 20/25 or better distance corrected near visual acuity (DCNVA), compared with 71% of the patients in the ReSTOR group, and 5% in the Crystalens group. All groups had good distance vision outcomes.
Although the three groups reported good overall visual satisfaction without correction, the Tecnis IOL group had the least difficulty reading without spectacles, with 93.9% of the patients able to read small print without glasses, compared to 58.8% in the ReSTOR group, and 47.1% in the Crystalens group.
When asked if they would elect to have the same lens implanted again, 93.9% of the patients in the Tecnis IOL group responded "yes or likely," compared with 76.5% in the ReSTOR group, and 75% in the Crystalens group.