Angle Kappa is Not Correlated with Patient-Reported Outcomes After Multifocal Lens Implantation

Abstract

Purpose

To examine the effect of preoperative angle kappa on patient-reported outcomes after multifocal lens placement during cataract surgery and determine if it is an effective measure for preoperative patients screening for multifocal lens placement.

Setting

Private refractive surgery clinics.

Design

Retrospective cohort study.

Methods

All patients undergoing bilateral cataract or refractive lens exchange surgery with a target of emmetropia between 2013 and 2017 at Optical Express (Glasgow, UK) with multifocal lens placement for whom preoperative angle kappa measurement and a postoperative month 1 patient-reported outcomes measures were available were included.

Results

A total of 1368 patients were identified. Median preoperative angle kappa was 0.41mm with an interquartile range of 0.30mm to 0.53mm. Preoperative angle kappa did not have a significant association with patient-reported satisfaction with vision (correlation coefficient 0.15, 95% confidence interval −0.081 to 0.39, P = 0.20) nor with patient-reported photic phenomena (P > 0.09 for all comparisons). A receiver-operator characteristic analysis did not yield a viable cutoff predictive of patient-reported satisfaction.

Conclusion

Angle kappa was not predictive of patient-reported satisfaction in this study. This study did not find evidence that it should be used as a screening test for patients considering multifocal intraocular lens placement.

Keywords:

• angle kappa
• multifocal intraocular lens
• refractive lens exchange

Disclosure

Hannan, SJ: Employee of Optical Express. Schallhorn, SC: Chief Medical Officer of Carl Zeiss, Meditec. He is also on the Medical Advisor Board of Optical Express. Schallhorn, JM: Consultant for Carl Zeiss, Meditec, Allergan, Neurotrigger, Forsight V6. Equity in Longbridge Medical, Novus Vision, Journey 1. The authors report no other conflicts of interest in this work.

Additional information

Funding

The Department of Ophthalmology at the University of California, San Francisco, is supported by an unrestricted educational grant from Research to Prevent Blindness, as well as a departmental Core Grant for Vision Research, NIH-NEI EY002162.