How important is patient satisfaction? Lifestyle questionnaires to the rescue

Jackson reports consulting for Alcon, Carl Zeiss Meditec, Johnson & Johnson, Oculus, RxSight and TearLab and being a shareholder in Visionary Venture Fund.

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At the recent ASCRS meeting in Washington, my fellow Abhi Guduru, MD, and I presented on “Quantifying postoperative satisfaction in patients with intraocular premium lenses” and were honored to share the value of lifestyle questionnaires.

We discovered that not only do lifestyle questionnaires improve the decision-making process of whether a premium IOL should be considered but further quantitate postoperative satisfaction in meeting patient demands based on the premium IOL ultimately selected.

Mitchell A. Jackson
Mitchell A. Jackson

Subjective preoperative testing with a modified Dell questionnaire and objective diagnostic preoperative testing with OPD-Scan III (Marco/Nidek), HD Analyzer (Keeler), Pentacam (Oculus), Cassini (i-Optics), IOLMaster 700 (Zeiss), OCT of the macula, tear film osmolarity (TearLab) and LipiView (Johnson & Johnson Vision) were performed in all patients in this evaluation.

The purpose of this analysis was to quantify postoperative satisfaction in patients with premium IOL technology relative to their own preoperative lifestyle questionnaire. The questionnaire had 23 activities of daily living consisting of near, intermediate and distance tasks that the patient would like to enjoy without glasses. Postoperatively at 1 month or greater, patients were asked if they were satisfied or unsatisfied for each of their preoperative marked activities. Satisfaction score was defined by the percent of satisfied activities and was analyzed by gender, age and preoperative refraction and among the various premium lenses.

The cross-sectional study of premium IOL patients occurred from October 2021 to January 2022 and included the Vivity or PanOptix IOL (Alcon), the Synergy IOL (Johnson & Johnson Vision) and the Light Adjustable Lens (RxSight). The target refraction for each of the IOLs was different for dominant and nondominant eyes: Light Adjustable Lens, plano and –0.75 sphere, respectively; PanOptix, first minus for both; Synergy, closest to plano or first plus for both; and Vivity, –0.25 sphere and –0.75 sphere, respectively. The study included 41 patients with a mean age similar for all four IOLs, averaging around 63 years old.

Data analysis revealed the highest satisfaction was in patients with preoperative hyperopic refraction, male gender and younger than age 65 years. Based on patient satisfaction for the specific premium IOL placed, the Light Adjustable Lens (n = 12) had a 97% satisfaction score, PanOptix (n = 16) 95%, Synergy (n = 1) 100% and Vivity (n = 12) 88%. The Light Adjustable Lens had a statistically significant higher patient satisfaction compared with both PanOptix and Vivity (P < .05).

To our knowledge, this is the first study to quantify patient satisfaction relative to preoperative lifestyle questionnaires. The preoperative subjective lifestyle questionnaire is as important as objective diagnostic testing for premium IOL selection. Quantifying postoperative patient satisfaction can help standardize and assess if patient demands are met and help guide future IOL decisions to enable greater patient satisfaction. Lifestyle questionnaires can definitely come to the rescue for premium surgeons. Continue to stay safe and healthy.