Vision-related Quality of Life in Glaucomatous Patients with multifocal Intraocular Lens

Abstract

Prcis: Glaucoma patients with multifocal intraocular lenses (MIOLs) reported comparable vision-related quality of life but greater spectacle independence than monofocal IOL users. MIOLs may be considered for mild to moderate glaucoma patients desiring spectacle-free.

Purpose: To compare the vision-related quality of life (VRQoL) in glaucomatous patients receiving bilateral monofocal intraocular lens (mIOL) and multifocal intraocular lens (MIOL) implantation.

Patients and methods: This was a comparative, non-randomized, unmasked, cross-sectional study in pseudophakic patients with mild to moderate glaucoma who underwent uneventful phacoemulsification with bilateral MIOL or mIOL implantation from January 2010 to June 2022 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. Data collection included distant and near best corrected visual acuity (BCVA), percent of spectacle independence and VRQoL. The 25-item National Eye Institute Visual Functional Questionnaire (NEI-VFQ-25) (translated into Thai) was used to access VRQoL (score 0 to 100). The scores were adjusted for age and glaucomatous staging using the analysis of covariance (ANCOVA).

Results: A total of 109 patients were enrolled. Fifty patients received MIOL and 59 received mIOL. There was significantly more moderate glaucoma in mIOL (39.7%) than MIOL group (17.5%) (P=0.002). Postoperatively, there was no statistically significant difference in BCVA, but MIOL group had significantly better uncorrected near VA (P<0.001). Spectacle-free was significantly greater in MIOL (78%) than mIOL (25.4%) (P<0.001). Mean adjusted NEI-VFQ-25 scores was 95.4 in MIOL and 93.5 in mIOL, which was not significantly different between groups (P=0.114).

Conclusion: Glaucomatous patients with multifocal IOL experienced comparable VRQoL, but more spectacle independence compared to monofocal IOL. Multifocal IOL could be considered in mild to moderate glaucomatous patients, who spectacle-free was warranted.

Keywords: cataract; glaucoma; multifocal intraocular lens; spectacle-free; vision-related quality of life.