Personality Traits and Patient-Reported Outcomes after Multifocal Intraocular Lens Implantation

Abstract

INTRODUCTION: Multifocal intraocular lenses (MIOLs) are implanted to achieve spectacle independence. Although refractive and visual outcomes are generally favorable, photic phenomena and loss of contrast may reduce satisfaction. Beyond optical factors, interindividual personality differences may influence postoperative perceptions. This study aimed to investigate the relationship between personality traits and patient-reported outcomes following MIOL implantation.

METHODS: Retrospective study of patients undergoing bilateral cataract extraction with MIOL implantation (Finevision® and Optiflex Trio®). Personality traits were assessed using the NEO-FFI-20. Subjective outcomes were measured with a validated 12-item questionnaire. Descriptive statistics and cross-tabulations explored associations between traits and reported outcomes.

RESULTS: Thirty-six eyes from 18 patients were included. Dominant traits were Conscientiousness in 6 patients (33%), Agreeableness in 5 (28%), Openness in 4 (22%), Extraversion in 2 (11%), and Neuroticism in 1 (6%). Seventeen patients (94.4%) were satisfied with visual results; all (100%) would repeat surgery. Glare at night was reported by 9 patients (50%), halos by 4 (22%), and visual fatigue by 2 (11%). Functional performance was preserved: 15 patients (83.3%) had no driving difficulty, and all reported no impairment in daily tasks. Lens-specific analysis showed 100% satisfaction in the Finevision group, with 14.3% reporting halos and none requiring near correction, but 50% reporting nocturnal glare. In the Optiflex group, satisfaction reached 75%, with 50% reporting halos and 25% requiring near correction, though daytime glare was less frequent. When stratified by personality, Conscientiousness or Agreeableness patients reported consistently high satisfaction, despite glare and halos in 47% and 21%, respectively. The single Neuroticism case reported neutral satisfaction despite no functional impairment.

CONCLUSION: Personality traits influence subjective outcomes after MIOL implantation. Conscientiousness and Agreeableness were linked to high satisfaction and preserved function, even with photic phenomena. Neuroticism, although rare, was associated with neutral satisfaction. Differences between Finevision and Optiflex in halos and spectacle dependence reflected optical design, but acceptance remained high, with all patients willing to repeat or recommend surgery. These findings highlight the relevance of integrating psychological profiling with clinical evaluation in the preoperative selection process, as rigorous screening may contribute decisively to optimizing postoperative satisfaction in refractive cataract surgery.