Grzybowski Andrzej, Kanclerz Piotr, Muzyka-Woźniak Maria
Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland.
Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Gorczyczewskiego 2/3, 60-554, Poznan, Poland.
Graefes Arch Clin Exp Ophthalmol. 2019 Jun;257(6):1091-1099. doi: 10.1007/s00417-019-04270-w. Epub 2019 Mar 1.
Cataract surgery has evolved into a procedure that generally yields the best postoperative refractive result attainable. Patients with multifocal intraocular lenses (IOLs) present higher rates of spectacle independence, although reduced intermediate vision, dysphotopsias, and a loss of image quality might also be experienced. The aim of the study was to review the methods for assessing quality of life and vision in patients undergoing lens refractive surgery in randomized controlled trials.
We reviewed the PubMed web platform to identify relevant studies using the following keywords: quality of life, quality of vision, lens surgery, lens exchange, refractive lens exchange, cataract, cataract surgery, intraocular lens, IOL, multifocal, and monovision.
An increasing number of studies have focused on patient-reported outcomes (PROs). Only a few of the available visual function questionnaires can be regarded as useful in lens refractive surgery with multifocal IOL implantation. Many self-developed questionnaires have emerged that have not been adequately validated or found to feature properly evaluated repeatability, hampering the possibility of comparing outcomes.
This review describes the existing PROs instruments and informs the choice of an appropriate measure in lens refractive surgery. Rasch-developed tools should be utilized for measuring quality of life and vision in patients undergoing lens refractive surgery and there is a number of highly robust tools available.
白内障手术已发展成为一种通常能产生可达到的最佳术后屈光效果的手术。植入多焦点人工晶状体（IOL）的患者实现脱镜率更高，不过可能也会出现中视力下降、眩光以及图像质量降低的情况。本研究的目的是回顾随机对照试验中评估晶状体屈光手术患者生活质量和视力的方法。
我们检索了PubMed网络平台，使用以下关键词来识别相关研究：生活质量、视觉质量、晶状体手术、晶状体置换、屈光性晶状体置换、白内障、白内障手术、人工晶状体、IOL、多焦点和单眼视。
越来越多的研究关注患者报告结局（PROs）。在多焦点IOL植入的晶状体屈光手术中，仅有少数现有的视觉功能问卷被认为有用。出现了许多自行开发的问卷，但这些问卷尚未得到充分验证，也未发现具有经过适当评估的可重复性，这妨碍了比较结果的可能性。
本综述描述了现有的PROs工具，并为晶状体屈光手术中选择合适的测量方法提供依据。在晶状体屈光手术患者的生活质量和视力测量中应使用Rasch开发的工具，并且有许多非常可靠的工具可供使用。
