Dataset Information

Relations between patient personality and patients' dissatisfaction after multifocal intraocular lens implantation: clinical study based on the five factor inventory personality evaluation.

ABSTRACT: To assess the level of visual function and the influence of personality traits on patients' (pts) satisfaction with the visual function following the four different MIOL implantation.

Methods

We evaluated the visual outcomes over a 6 months follow-up period after cataract surgery with bilateral implantation of four different multifocal IOLs. The spectacle independence, photic phenomena, the influence of personality traits on patients' satisfaction with the visual function were assessed.

Results

A total of 170 eyes of 85 pts were included. There was no statistically significant difference in UDVA (F = 1.6 p = 0.177) and CNVA (F = 1.2 p = 0.30) between the groups 6 months after the surgery. The ReSTOR group had a worse CDVA than the M-flex (p = 0.019) and TECNIS (p = 0.005) groups. The ReSTOR and AT.LISAtri groups had a statistically significantly better UNVA than the M-flex (p = 0.020 and p = 0.013) and TECNIS groups (p = 0.001 both). The independence on spectacles for near distance was from 71.8% (in M-flex group) to 100% (in ReSTOR). The answers of the pts with the prevailing neurotic personality type contradicted the answers given by the pts with other prevailing personality types (p < 0.01).

Conclusions

MIOL implantation helped ensure better postoperative visual acuity, but some pts were unhappy with the postoperative outcomes. It was established that the subjective satisfaction or dissatisfaction of patients after MIOL implantation is related to certain personality traits: pts with neuroticism as the dominant personality trait were least happy with the postoperative outcomes; pts with conscientiousness and agreeableness as dominant personality traits demonstrated the highest satisfaction with the postoperative outcomes.

SUBMITTER: Rudalevicius P

PROVIDER: S-EPMC7093406 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo determine the cost effectiveness of an adjunctive screening OCT during the preoperative evaluation of a patient considering cataract surgery with a multifocal intraocular lens (IOL) implantation.DesignCost-effectiveness analysis.ParticipantsA 67-year-old man with 20/60 vision undergoing evaluation for first-eye cataract surgery.MethodsThe cost-effectiveness analysis of the reference patient undergoing a preoperative cataract examination with and without a screening OCT was performed, evaluating for vitreoretinal diseases including an epiretinal membrane, age-related macular degeneration, vitreomacular traction, and cystoid macular edema. It was assumed that patients with macular pathologies detected before surgery would receive a monofocal IOL and be referred to a retina specialist for evaluation and management. The Medicare reimbursable cost of an OCT was $41.81. All costs and benefits were adjusted for inflation to 2019 United States dollars and discounted 3% per annum over a 16-year time horizon. Probability sensitivity analyses and 1-way deterministic sensitivity analyses were performed to assess for uncertainty.Main outcome measuresIncremental cost-effectiveness ratio and incremental cost-utility ratio (ICUR) measured in quality-adjusted life years (QALYs).ResultsApproximately 20.5% of patients undergoing cataract surgery may have macular pathologies, of which 11% may not be detected on the initial clinical examination. In the base case, an adjunctive preoperative OCT was cost effective from a third-party payer and societal perspective in the United States. In the probability sensitivity analyses, the ICURs were within the societal willingness-to-pay threshold of $50 000/QALY in approximately 64.4% of the clinical scenarios.ConclusionsA preoperative screening OCT during the evaluation of a patient considering a multifocal IOL added to the costs of the cataract surgery, but the OCT increased the detection of macular pathologies and improved the QALYs over time. An adjunctive screening OCT can be cost effective from a third-party payer and societal perspective.