Department of Ophthalmology, Northwestern University, Fienberg School of Medicine, 645 N. Michigan Avenue, Suite 440, Chicago, IL, 60611, USA.
Eye (Lond). 2019 Oct;33(10):1635-1641. doi: 10.1038/s41433-019-0460-9. Epub 2019 May 14.
Contemporary cataract surgery is increasingly customizable with the advent of presbyopia-correcting intraocular lenses (IOLs) and the femtosecond laser. The purpose of this study was to determine the types of IOLs ophthalmologists choose for themselves and whether demographic characteristics, surgical experience, and attitudes of ophthalmologists might influence their decision-making. Additional goals included evaluating the use of femtosecond laser use in cataract surgery and investigating surgeon IOL preferences for their patients.
We distributed a 29-question Survey Monkey survey to senior ophthalmology residents and practicing ophthalmologists and received 347 responses during a 1-month period. We analyzed 328 surveys using chi-square tests and Fisher's exact tests.
Main outcome measures included surgeons' personal preferences for choice of IOL, femtosecond laser-assisted cataract surgery, and IOL preference for patients. In the setting of no astigmatism, 61.3% of respondents would choose a monofocal IOL set for either distance or monovision for their own surgery. For corneal astigmatism >1.25 D, 60.3% of respondents would choose a toric monofocal lens and only 6.9% would want a femtosecond laser or manual LRI for their own surgery. Of the respondents, 34.6% perform femtosecond laser-assisted cataract surgery, but only 15.3% would want femtosecond cataract surgery performed on themselves. Also, 67.7% implant presbyopia-correcting IOLs (diffractive echelette, multifocal, or accommodative). When correcting for patients' corneal astigmatism >1.25 D, 65.7% of respondents preferred a toric monofocal IOL.
Ophthalmologists value quality of vision and are risk averse. Overall, a surgeons' personal preference for their own surgery is correlated with past surgical experience with patients.
随着矫正老视的眼内晶状体（IOL）和飞秒激光的出现，现代白内障手术的可定制性越来越强。本研究旨在确定眼科医生为自己选择的 IOL 类型，以及人口统计学特征、手术经验和眼科医生的态度是否会影响他们的决策。其他目标包括评估飞秒激光在白内障手术中的使用情况以及调查外科医生对患者的 IOL 偏好。
我们向高级眼科住院医师和执业眼科医生发放了一份包含 29 个问题的 Survey Monkey 调查，在一个月的时间内收到了 347 份回复。我们使用卡方检验和 Fisher 确切检验分析了 328 份调查。
主要观察指标包括外科医生对 IOL 选择、飞秒激光辅助白内障手术和患者 IOL 偏好的个人偏好。在没有散光的情况下，61.3%的受访者会选择单焦点 IOL 集，用于自己的手术，以获得距离或单视。对于>1.25 D 的角膜散光，60.3%的受访者会选择矫正散光的单焦点晶状体，只有 6.9%的人会希望自己的手术采用飞秒激光或手动 LRI。在受访者中，34.6%的人进行飞秒激光辅助白内障手术，但只有 15.3%的人希望自己接受飞秒白内障手术。此外，67.7%的人植入矫正老视的 IOL（衍射光栅、多焦点或调节性）。当矫正患者>1.25 D 的角膜散光时，65.7%的受访者更喜欢矫正散光的单焦点 IOL。
眼科医生重视视力质量，并且回避风险。总体而言，外科医生对自己手术的个人偏好与他们对患者的既往手术经验相关。
