ArticleClinical ophthalmology (Auckland, N.Z.)2024
The Multifocal Pathway: A Pilot Study of a Trainee-Led Multifocal Intraocular Lens Protocol in a Tertiary Referral Hospital in Australia.
Article in Clinical ophthalmology (Auckland, N.Z.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Outcomes of Extended Monofocal and Extended Depth of Focus Intraocular Lens Implantation by a Trainee Surgeon in an Australian Tertiary Public Hospital.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To develop a selection pathway to facilitate the use of multifocal intraocular lenses (mfIOLs) in cataract surgery in a public hospital setting. Methods: A single-surgeon prospective cohort study in an Australian tertiary referral public hospital was conducted. A mfIOL selection pathway was designed and assessed. Outcomes measured included unaided distance (UDVA), intermediate (UIVA) and near visual acuity (UNVA), dysphotopsia, spectacle dependence and satisfaction. Patient-reported outcome measures (PROMs) were assessed using Catquest-9SF (CQ) and Near Visual Acuity Questionnaire (NAVQ). A cost-analysis was performed. Results: Fifty-four eyes from 27 patients underwent cataract surgery with mfIOL implantation. The monocular UDVA (mean ± standard deviation) was 0.05 ± 0.12 logMAR; UIVA 0.19 ± 0.05 logMAR; UNVA 0.28 ± 0.14 logMAR; 87% and 98% of eyes achieved within 0.5D and 1.0D of target refraction respectively. Spectacle independence was 85% at distance, 81% at intermediate, 59% at near vision. High satisfaction was reported with CQ (>85%) and NAVQ (100%). The cost difference between bilateral monofocal and mfIOLs is comparable to a pair of spectacles. Projected annual cost to the health system for a 5%-10% eligibility rate is 1.1-2.3 million Australian dollars. Conclusion: The selection pathway presented overcomes the challenges in patient selection inherent to a public hospital setting and was implemented by a senior trainee with excellent vision and PROMs. The pathway ensures the cost-effectiveness of mfOL implantation. There are several funding models that can be applied to support equitable access and improved visual outcomes with mfIOLs within the government funded health system.
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