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探索年龄相关性白内障患者对人工晶状体选择的偏好:一项离散选择实验研究。

Exploring patient preferences for intraocular lenses selection in age-related cataract: a discrete choice experiment study.

作者信息

Zhu Qiaolin, Sun Qianqian, Huo Yujia, Yang Xiaoling, Huang Hehe, Qian Shanshan, Lin Wenjing, Yan Wentao

机构信息

National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.

National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China.

出版信息

Front Med (Lausanne). 2025 Feb 12;12:1446715. doi: 10.3389/fmed.2025.1446715. eCollection 2025.

Abstract

INTRODUCTION

This study investigates the preferences of cataract patients in East China regarding intraocular lenses (IOLs).

METHODS

A Discrete Choice Experiment (DCE) was conducted using a questionnaire that included various IOLs attributes. Participants made choices based on different combinations of these attributes, and the data were analyzed using multinomial logit models (MNL) and latent class analysis (LCA) to identify preference heterogeneity.

RESULTS

A total of 200 cataract patients (mean age 66.2 years, 58.5% female) participated in the study. The most influential factors in IOL selection were cost, followed by presbyopia correction, with a preference for multifocal IOLs (trifocal and bifocal), spherical aberration correction, and astigmatism correction. High cost and a higher probability of adverse visual phenomena negatively affected preferences. The inclusion of blue-blocking functionality and the surgeon's recommendation had minimal influence on patient choice. LCA revealed three distinct preference groups: Class 1 ("Aberration Correction Seekers") preferred aspheric IOLs, Class 2 ("Presbyopia and Blue-Blocking Enthusiasts") favored multifocal IOLs, and Class 3 ("Astigmatism and Cost-Sensitive Patients") preferred toric IOLs. Multinomial logistic regression analysis further showed that male patients were more likely to choose toric IOLs, while individuals with higher education levels were significantly less likely to prefer multifocal IOLs.

CONCLUSION

This study highlights significant heterogeneity in cataract patient preferences for IOLs attributes. Cost was the most critical factor, followed by presbyopia and aberration correction. Men favored toric IOLs and exhibited sensitivity to cost, while highly educated individuals preferred multifocal IOLs less. These findings underscore the need for personalized IOLs recommendations and signal opportunities for innovation and customization in the IOLs industry.

摘要

引言

本研究调查了中国东部白内障患者对人工晶状体(IOL)的偏好。

方法

采用包含各种IOL属性的问卷进行离散选择实验(DCE)。参与者根据这些属性的不同组合做出选择,并使用多项logit模型(MNL)和潜在类别分析(LCA)对数据进行分析,以识别偏好异质性。

结果

共有200名白内障患者(平均年龄66.2岁,女性占58.5%)参与了该研究。IOL选择中最具影响力的因素是成本,其次是老花眼矫正,患者更倾向于多焦点IOL(三焦点和双焦点)、球差矫正和散光矫正。高成本和不良视觉现象的较高发生率对偏好产生负面影响。蓝光阻挡功能的加入和医生的建议对患者选择的影响最小。LCA揭示了三个不同的偏好组:第1组(“像差矫正追求者”)更喜欢非球面IOL,第2组(“老花眼和蓝光阻挡爱好者”)青睐多焦点IOL,第3组(“散光和成本敏感患者”)更喜欢 toric IOL。多项逻辑回归分析进一步表明,男性患者更有可能选择toric IOL,而受教育程度较高的个体明显不太可能偏好多焦点IOL。

结论

本研究突出了白内障患者对IOL属性偏好的显著异质性。成本是最关键的因素,其次是老花眼和像差矫正。男性青睐toric IOL并对成本敏感,而受教育程度高的个体不太喜欢多焦点IOL。这些发现强调了个性化IOL推荐的必要性,并为IOL行业的创新和定制提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc1c/11861010/254ad97cca10/fmed-12-1446715-g001.jpg

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