Patient-reported outcomes and visual function after four refractive strategies in cataract surgery: A randomized controlled trial.
Anne Guldhammer Skov, Morten la Cour, Birgitte Moldow et al.
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In 30 seconds
This randomized controlled trial compared patient-reported outcomes (PROMs) and visual function after four refractive strategies in 188 patients with bilateral symptomatic cataract: emmetropia, mini-monovision, monovision, and partial-range-of-field extended intraocular lenses. PROM scores improved substantially in all groups, with no statistically significant between-group differences. Mini-monovision and extended lenses had comparable visual performance, spectacle independence, and safety. Monovision improved uncorrected near vision and reduced spectacle use, but was associated with poorer binocular distance vision, more halos, impaired stereoacuity, and a 6.7% reoperation rate for binocular visual complaints.
Key findings
- PROM scores improved across all four groups, with no statistically significant differences between groups.
- All patients achieved binocular best-corrected distance visual acuity of logMAR 0.12 or better (range 0.12 to -0.26).
- Mini-monovision and partial-range-of-field extended lenses had comparable visual performance, spectacle independence, and safety.
- Monovision improved uncorrected near vision and reduced spectacle use, but had a 6.7% reoperation rate for binocular visual complaints.
Why it matters
The findings show that several refractive strategies can yield substantial patient-reported and visual-function improvement after bilateral cataract surgery, while their trade-offs differ. In particular, better near vision and less spectacle use with monovision occurred alongside binocular visual disadvantages and more halos. Considering both patient-reported outcomes and binocular function helps characterize these trade-offs rather than relying on acuity alone.