Enhancing Visual Outcomes and Patients’ Satisfaction: A Case Series of Mix-and-Match Approach for Unhappy Presbyopic Patients Post-Cataract Surgery
- Author:
See Yee Bee
1
;
See Yee Bee
2
;
Jemaima Che Hamzah
1
;
Jemaima Che Hamzah
2
;
Rona Asnida Nasaruddin
1
;
Rona Asnida Nasaruddin
2
;
Teck Chee Cheng
1
;
Teck Chee Cheng
2
Author Information
- Publication Type:Journal Article
- Keywords: Contrast sensitivity; extended-depth of focus; intraocular lens; intermediate vision; mix-and-match; presbyopia
- From: Journal of Surgical Academia 2025;15(1):13-21
- CountryMalaysia
- Language:English
- Abstract: Enhancing Visual Outcomes and Patients’ Satisfaction: A Case Series of Mix-and-Match Approach for Unhappy Presbyopic Patients Post-Cataract Surgery:This case series explored the mix-and-match approach of implanting an extended depth of focus (EDOF) intraocular lens (IOL) in the fellow eye to improve visual outcomes, reduce spectacle dependence, and enhance satisfaction in presbyopic patients dissatisfied with monofocal IOL outcomes, highlighting personalised refractive solutions for suboptimal results post-cataract surgery. Seven patients dissatisfied with post-operative presbyopia following monofocal IOL in first eye received EDOF IOL in the second eye (mix-and-match approach). Visual outcomes were assessed using a logMAR chart for near (40 cm), intermediate (60 cm and 80 cm) and distance (6 m) visual acuity (VA). Contrast sensitivity was measured using the Pelli-Robson chart, and halos and glare were evaluated with the Zeiss Halo and Glare Stimulator. Patient satisfaction was measured using the CATQUEST-9SF 2011 questionnaire before and after EDOF IOL implantation in the second eyes. Results showed statistically significant improvement in uncorrected near VA at 40cm and intermediate VA at 60cm in eyes with EDOF IOL (0.26 ± 0.18 and 0.11 ± 0.15 respectively) compared to eyes with monofocal IOL (0.64 ± 0.28 and 0.39 ± 0.26 respectively), while maintaining good uncorrected distance VA. Only one patient reported halos with the EDOF IOL, not affecting night driving. Contrast sensitivity showed no significant difference between monofocal IOL (1.60 ± 0.14) and EDOF IOL (1.60 ± 0.17) eyes. All patients were satisfied, experiencing improvements in recognised faces, walking on uneven surfaces, reading newspapers and TV subtitles, engaging in hobbies and seeing price tags. This mix-and-match approach demonstrated efficacy in enhancing near and intermediate vision while maintaining good distance vision, offering a personalised solution to reduce spectacle dependence without compromising contrast sensitivity or causing significant halos and glare.
- Full text:2026072216380520312Enhancing.pdf
