Abstract

DO.25.02

Influence of visual symptoms on subjective quality of vision after LASIK and pIOL Implantation

Jens Bühren, Anja Kühne, Thomas Kohnen

Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Frankfurt/Main

Objective
To assess the influence of visual symptoms on subjective quality of vision after laser in situ keratomileusis (LASIK) and implantation of an intraocular lens in the phakic eye (pIOL implantation).
Methods
Ninety-three myopic patients were included.  Sixty-one patients (118 eyes) had uneventful LASIK; in 32 patients (60 eyes) a pIOL was implanted.  In the LASIK group the mean age was 37 ±8 years (pIOL: 37 ±7); the mean preoperative spherical equivalent was -4.35 ±2.07 dpt (pIOL: -9.63 ±4.75).  One month postoperatively all patients completed a questionnaire that differred between right and left eye and between three lighting conditions (photopic, high-mesopic and low-mesopic).  The intensity of the symptoms „glare“, „haloes“, „starbursts“, „blurry vision“, „ghosting“ and the subjective quality of vision (SQV) was marked on a visual analogue scale (0-100).  The influence of the symptoms on SQV was assessed using a multiple stepwise backward regression model.
Results
Under photopic conditions SQV was 22 ±20 (pIOL: 17 ±16), under high-mesopic conditions 21 ±20 (pIOL: 16 ±15) and under low-mesopic conditions 32 ±22 (pIOL: 30 ±16).  The coefficients of determination for the three conditions were 66.9% (pIOL: 60.1%), 68.1% (pIOL: 61.2%) and 73.7% (pIOL: 59.8%).  After LASIK, the symptoms „glare“ and „blurry vision“ had the strongest impact on SQV.  In the pIOL group, glare, ghosting, haloes and starbursts had significant influence on SQV, although the symptom profiles were more heterogeneous.
Conclusions
The present study showed that two thirds of the variance of SQV could be explained by the symptoms examined by the questionnaire.  Blurry vision, ghosting and glare were the symptoms with most significant influence.

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