Work Intensity of Postoperative Care Following Implantation of Presbyopia-Correcting versus Monofocal Intraocular Lenses

Abstract

Purpose

To compare the work intensity of postoperative care following implantation of presbyopia-correcting intraocular lenses (IOLs) to that of standard monofocal IOLs.

Patients and Methods

This open-label, multicenter, comparative study retrospectively reviewed the case records of cataract surgery patients who underwent bilateral implantation of either presbyopia-correcting IOLs (presby-IOL group; N=177) or standard monofocal IOLs (monofocal group; N=177). Outcome measures included the total time the patient spent in the office, number of visits, mean duration of visits, and the number of procedures and diagnostic tests during the first postoperative year. Outcome measures were compared between the first 90 days and days 91–365 after surgery.

Results

Mean (±SD) time spent in the office during the first postoperative year was 5:50 ± 3:35 hours (H:MM) over 6.6 ± 2.9 visits in the presby-IOL group, compared to 3:38 ± 1:36 hours over 4.9 ± 1.6 visits in the monofocal IOL group (p <0.001). During the first 90 days, a presby-IOL patient spent 40 minutes longer in the office than a monofocal IOL patient (3:39 ± 1:38 hours vs 2.59 ± 1:13 hours) (p <0.001). During days 91–365, time in the office was 1:32 hours longer (p <0.001), and the mean visit duration was 8 minutes longer for the presby-IOL patients (p=0.002) than those with monofocal IOL. In addition, the presby-IOL patients underwent more procedures and diagnostic tests (p ≤0.001) as compared with standard monofocal cataract surgery patients.

Conclusion

Patients implanted with presbyopia-correcting IOLs require significantly more clinic time, diagnostic testing, and procedures postoperatively as compared with standard monofocal cataract surgery patients.

Keywords:

• AECOS
• presbyopia-correcting IOLs
• multifocal IOLs
• cataract surgery
• work intensity of postoperative care

Abbreviations

AECOS, American European Congress of Ophthalmic Surgery; IOLs, intraocular lenses; Nd:YAG, Neodymium-doped yttrium aluminium garnet; CMS, Centers for Medicare and Medicaid Services; FDA, Food and Drug Administration; EDOF, extended depth of focus; COVID, coronavirus disease; HER, electronic health record; CPT, current procedural terminology; LASIK, laser-assisted in situ keratomileusis; GEE, Generalized Estimating Equations; OCT, Optical Coherence Tomography.

Data Sharing Statement

The data used to support the findings of this study are included within the article. Clarifications or additional data used to support the findings of this study may be requested from the corresponding author.

Acknowledgments

1. AECOS Postoperative Care Study Group: Bala Ambati, MD; Stephen Bylsma, MD; John Doane, MD; Eric Donnenfeld, MD; Gary Foster, MD; Damien Goldberg, MD; Tyrie Jenkins, MD; Mark Kontos, MD; Kathleen Leone, MD; Beeran Meghpara, MD; Tim Page, MD; Jay Pepose, MD; Maria Scott, MD; Jonathan Solomon, MD; William Wiley, MD; Blake Williamson, MD; Elizabeth Yeu, MD.

2. The research, statistical, and editorial assistance was provided by Raman Bedi, MD (IrisARC - Analytics, Research & Consulting, Chandigarh, India) and Jan Beiting (Wordsmith Consulting, Cary, North Carolina, USA) for the preparation of this manuscript.

Disclosure

RKM is a consultant to Johnson and Johnson Vision, LENSAR, and Presbia, and an equity/stock holder of RxSight, Stroma Medical and Percept; He is also a consultant for and paid in stock options by Horizon Surgical. JD is a consultant to Zeiss and RxSight. RW is a consultant to Alcon, Bausch and Lomb, Johnson and Johnson Vision, LENSAR, and Zeiss; He also reports personal fees from Eye Point Pharma, Beyeonics, Visus (with ownership interest), BVI, Trefoil, and RxSight (with ownership interest). KED is a consultant to Alcon, Johnson and Johnson, Bausch and Lomb and Zeiss.

Additional information

Funding

The study was supported by the American European Congress of Ophthalmic Surgery (AECOS) and an investigator-initiated grant from Alcon, Inc.