Intraocular Lens’ Own Choice by Portuguese Ophthalmologists
DOI:
https://doi.org/10.48560/rspo.33274Keywords:
Cataract Extraction, Lens Implantation, Intraocular, Lenses, Intraocular, Ophthalmologists, Portugal, Practice Patterns, Physicians, Surveys and QuestionnairesAbstract
INTRODUCTION: Cataract surgery has evolved considerably in recent years and is now considered refractive surgery. The possibility of surgically manage presbyopia surgically raised patients’ expectations and their desire for glasses independence. Intraocular lens (IOL) selection is a crucial step in cataract surgery, and there is currently a wide range of options available to meet patients’ needs. However, some IOLs have adverse effects that can compromise refractive outcomes, limiting their acceptance by ophthalmologists. We aimed to investigate the preferences of Portuguese ophthalmologists when selecting IOLs for their own cataract surgeries.METHODS: A Google Forms survey was available online for Portuguese ophthalmologists for two months. The survey included 29 questions on cataract surgery, focusing on IOL selection and presbyopia management. We compared their current options for their patients with their preferences for their own cataract surgery. The responses were statistically analyzed. Statistical significance was defined as a p-value < 0.05.
RESULTS: One hundred twenty one ophthalmologists participated in the survey: 94 seniors (77.68%) and 27 residents (22.31%). Of the ophthalmologists, 80% use premium IOLs, mainly multifocal, with a clear preponderance of corneal and refractive surgeons. Almost all corneal and refractive surgeons always ask their patients with cataract about the desired spectacle independence. Of those surveyed, 30% manage presbyopia surgically in patients without cataract, but only 11% said they would choose this procedure for themselves. A percentage of 9.01% reported using femtosecond laser-assisted cataract surgery, but nearly 30% expressed a desire to use this technology in their own cataract surgeries. All residents seek some degree of spectacle independence after cataract surgery, while most seniors prefer to be independent only for distance.
CONCLUSION: This study investigated the preferences of Portuguese ophthalmologists in the treatment of presbyopia, whether for their patients or for themselves, and showed slight differences in the responses. Surgeons were significantly less likely to manage presbyopia surgically for themselves than for their patients. Refractive surgeons and ophthalmologists with more years of experience were more likely to opt for multifocal IOLs for patients with cataract and for patients with presbyopia and without cataract. Ophthalmologists prioritize the quality of vision and avoid risks. It is critical for cataract surgeons to weigh the factors that influence their preferences in order to effectively guide their patients choose the most appropriate solution.
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References
Davis G. The evolution of cataract surgery. Mo Med. 2016;113:58–62.
Saraiva J, Neatrour K, Waring Iv GO. Emerging technology in refractive cataract surgery. J Ophthalmol. 2016;2016:7309283. doi: 10.1155/2016/7309283.
Bianchi GR. Spectacle independence after cataract surgery: a prospective study with a multifocal intraocular lens. Med Hypothesis Discov Innov Ophthalmol. 2020;9:38–46.
ESCRS Clinical Trends Survey 2022 Results. [accessed Jan 2023]. Available from: https://www.escrs.org/media/5cbb4kx4/2022_escrs_clinical-survey-supplement.pdf,
Janssen SJ, Teunis T, Guitton TG, Ring D. Do surgeons treat their patients like they would treat themselves? Clin Orthop Relat Res. 2015;473:3564–3572. doi: 10.1007/s11999-015-4304-z.
Logothetis HD, Feder RS. Which intraocular lens would ophthalmologists choose for themselves? Eye. 2019;33:1635–41. doi: 10.1038/s41433-019-0460-9.
Kamiya K, Negishi K. Editorial: Recent advances in refractive surgery. Front Med. 2023;10:1270240. doi: 10.3389/fmed.2023.1270240.
Torricelli AA, Junior JB, Santhiago MR, Bechara SJ. Surgical management of presbyopia. Clin Ophthalmol. 2012;6:1459-66. doi: 10.2147/OPTH.S35533.
Sieburth R, Chen M. Intraocular lens correction of presbyopia. Taiwan J Ophthalmol. 2019;9:4.
Shafer BM, Greenwood M. Presbyopia correction at the time of cataract surgery. Curr Ophthalmol Rep. 2020;8:79–87. doi:10.1007/s40135-020-00236-y.
Papadopoulos PA, Papadopoulos AP. Current management of presbyopia. Middle East Afr J Ophthalmol. 2014;21:10–7. doi: 10.4103/0974-9233.124080.
Finkelman YM, Ng JQ, Barrett GD. Patient satisfaction and visual function after pseudophakic monovision. J Cataract Refract Surg. 2009;35:998–1002. doi: 10.1016/j.jcrs.2009.01.035.
Leccisotti A. Secondary procedures after presbyopic lens exchange. J Cataract Refract Surg. 2004;30:1461–5. doi: 10.1016/j.jcrs.2003.11.056.
Wolffsohn JS, Davies LN, Sheppard AL. New insights in presbyopia: impact of correction strategies. BMJ Open Ophthalmol. 2023;8:e001122. doi: 10.1136/bmjophth-2022-001122.
Kanclerz P, Toto F, Grzybowski A, Alio JL. Extended Depth-of-Field Intraocular Lenses: An Update. Asia Pac J Ophthalmol. 2020;9:194-202. doi: 10.1097/APO.0000000000000296.
Savini G, Schiano-Lomoriello D, Balducci N, Barboni P. Visual Performance of a New Extended Depth-of-Focus Intraocular Lens Compared to a Distance-Dominant Diffractive Multifocal Intraocular Lens. J Refract Surg. 2018;34:228-35. doi: 10.3928/1081597X-20180125-01.
Titiyal JS, Kaur M, Bharti N, Singhal D, Saxena R, Sharma N. Optimal near and distance stereoacuity after binocular implantation of extended range of vision intraocular lenses. J Cataract Refract Surg. 2019;45:798-802. doi: 10.1016/j.jcrs.2018.12.024.
Cochener B, Boutillier G, Lamard M, Auberger-Zagnoli C. A Comparative Evaluation of a New Generation of Diffractive Trifocal and Extended Depth of Focus Intraocular Lenses. J Refract Surg. 2018;34:507-14. doi: 10.3928/1081597X-2018053002.
Mencucci R, Favuzza E, Caporossi O, Savastano A, Rizzo S. Comparative analysis of visual outcomes, reading skills, contrast sensitivity, and patient satisfaction with two models of trifocal diffractive intraocular lenses and an extended range of vision intraocular lens. Graefes Arch Clin Exp Ophthalmol. 2018;256:1913-22. doi: 10.1007/s00417-018-4052-3.
Ruiz-Mesa R, Abengózar-Vela A, Ruiz-Santos M. A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens. Eur J Ophthalmol. 2018;28:182–7. doi: 10.5301/ejo.5001029.
Hooshmand J, Vote BJ. Femtosecond laser-assisted cataract surgery, technology, outcome, future directions and modern applications. Asia Pac J Ophthalmol. 2017;6:393-400. doi: 10.22608/APO.2017159.
Sun H, Fritz A, Dröge G, Neuhann T, Bille JF. Femtosecond-Laser-Assisted Cataract Surgery (FLACS). 2019 Aug 14. In: Bille JF, editor. High Resolution Imaging in Microscopy and Ophthalmology: New Frontiers in Biomedical Optics. Cham: Springer; 2019. Chapter 14.
Roberts HW, Day AC, O’Brart DP. Femtosecond laser-assisted cataract surgery: A review. Eur J Ophthalmol. 2020;30:417-29. doi: 10.1177/1120672119893291.
Chen X, Xiao W, Ye S, Chen W, Liu Y. Efficacy and safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification for cataract: a meta-analysis of randomized controlled trials. Sci Rep. 2015;5:13123. doi: 10.1038/srep13123.
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