Visual performance and quality of vision questionnaire outcomes in multifocal intraocular lens use

  • Richard McNeely

Student thesis: Doctoral Thesis


This thesis aimed to investigate the current most advocated methodology for visionrelated questionnaire analysis following multifocal intraocular (IOL) implantation. Initial efforts focused on investigating the use and the validity of the Rasch model on a quality of vision (QoV) questionnaire at two postoperative periods. The research then focused on the effect of lifestyle on the QoV questionnaire and the importance of preoperative subcategorisation of groups to allow adequate assessment of QoV.
The QoV questionnaire was then utilised to assess the visual performance and QoV of rotationally asymmetric multifocal IOLs. The individual visual symptom items of the QoV questionnaire and an overall 0-10 score were used to compare QoV between postoperative periods and asymmetric multifocal IOLs. The visual performance and QoV of an asymmetric multifocal IOL was compared at 3 and 12 months. Next the two commercially available asymmetric multifocal IOLs were compared 12 months postoperatively. Additionally, the effect of residual postoperative astigmatism upon the QoV obtained using the asymmetric multifocal IOLs was further investigated.
Rotationally asymmetric multifocal IOLs can be placed in different rotational positions and different powers of near additions (add) are available. To further investigate the effect of different IOL placement on postoperative outcomes a superonasal placement in the dominant eye, with a lower near add power, in combination with inferonasal placement in the nondominant eye was investigated.
Overall, the research reported various shortcomings of the current analysis of vision-related questionnaires and outlined an alternative approach in how to utilise 4 the Rasch model in QoV measurements. The research also defined clear preoperative clinical parameters and intraocular surgical techniques to maximise postoperative visual performance and QoV achieved when implanting asymmetric multifocal IOLs.
Date of AwardMay 2018
Original languageEnglish
SupervisorTara Moore (Supervisor), Raymond Beirne (Supervisor) & John Moore (Supervisor)


  • Quality of Vision
  • Patient Reported Outcomes
  • Subjective Questionnaire
  • Asymmetric Multifocal IOLs
  • Visual Performance

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