Study On Satisfaction Of Vision Outcome With Bilateral Implantation Of Monofocal Intraocular Lens In Patient With Cataract And Myopia

Objective To investigate the visual satisfaction of cataract patients with myopia after phacoemulsification combined bilateral monofocal IOL implantation and to find the the influencing factors of patients’ postoperative visual satisfaction.According to the results of the study,clinicians could intervene the factors which might affect postoperative visual satisfaction,and improve the postoperative visual satisfaction of patients.At the same time,the results of the study could guide the other relevant clinical studies.Methods A retrospective case-control study was conducted to examine the medical records of cataract patients with myopia who underwent phacoemulsification combined with bilateral monofocal IOL implantation in Anhui Provincal Hospital from July 1,2020 to June 31,2021.Observation indicators:including preoperative and intraoperative basic medical records,such as age,gender,educational background,data related to ophthalmic instrument examination,the length of eye axis,operated eye,etc.Postoperative information,such as uncorrected distance visual acuity（UDVA）,uncorrected near visual acuity（UNVA）,post-operative optometry results,the preference of visual distance,spectacle independence.We also invited patients to fill in Visual Function Index-14（VF-14）to evaluate the subjective visual quality of life,and investigated patients with postoperative vision satisfaction.Univariate analysis was used to find the potential influencing factors.P value less than 0.05 was considered statistically significant.Results In this study,a total of 49 patients were included,21 males（42.9%of the total）and 28 females（57.1%of the total）.The number of people with high school education and junior college education is the largest,accounting for 40.8%of the total.In terms of preoperative and postoperative preferences of visual distance,more than two distance requirements were the majority,accounting for 46.9%and 51.1%of the total number,respectively.63.2%of the patients did not wear glasses after surgery.The postoperative difference power of binocular optometry spherical diopter M（P25,P75）=-0.25D（-0.75D,0.00D）.Postoperative binocular uncorrected distance visual acuity mean±SD=0.37±0.31,postoperative binocular uncorrected near visual acuity mean±SD=0.45±0.27.16%of the patients were completely satisfied with the postoperative visual acuity,55,1%of the patients were more satisfactory,24.4%of the patients were commonly satisfied,4.0%of the patients were less satisfied,and no patients were completely dissatisfied.The results of VF-14 visual function scale showed that the lower the difficulty of various life scenes,the higher the postoperative visual satisfaction of patients.After completing the comparison among the three groups,which are the complete satisfaction group,the more satisfaction group and the common satisfaction group.Univariate analysis showed that eight test results,including the patients’ gender,age,preferences of visual distance,the length of eye axis,postoperative time,postoperative difference power of binocular optometry spherical diopter,postoperative binocular uncorrected distance visual acuity,postoperative binocular uncorrected near visual acuity were no significant difference between the three groups（P>0.05）,Educational background（χ2=11.848,P=0.03）and postoperative spectacle independence（χ2=9.161,P=0.01）indicated a statistically significant difference（P<0.05）.Conclusion Patients’ educational background and postoperative spectacle independence significantly influenced patients’ postoperative satisfaction with their visual outcome.Poor educational background and high postoperative spectacle independence were associated with high postoperative satisfaction of visual outcome.Other factors,such as the preference of visual distance,preoperative length of eye axis,postoperative difference power of binocular optometry spherical diopter,and postoperative recovery time may affect postoperative satisfaction and should be further studied.Studies on visual satisfaction after cataract surgery should include or exclude the educational level of patients as a necessary consideration factor in the future.Although VF-14 is widely used and recognized as a visual acuity evaluation tool after cataract surgery in the world,the influence of the patient’s educational level on the evaluation results should also be considered when using this scale for cataract patients.