Supplementary Content: Patient Questionnaire

Was this refractive lens exchange (RLE) or cataract surgery?

RLE. I was unsatisfied with my glasses. You know with +5.5 D sphere and astigmatism of -2.5 D you basically see nothing without glasses!

Why did you choose a trifocal IOL?

The doctor spoke to me and explained me which lenses are available. He asked what my daily routine was and what I want to do without glasses. I said: I work as a surgical nurse, so I need to see the table in front of me. At night I like to read to my children and in my spare time I am very active. I had tried monovision with toric contact lenses, but I got dizzy and didn’t want that anymore. So when I heard about what multifocal IOLs could offer, I thought that might be the best option for me.

Were there specific work reasons for wanting a premium IOL?

Yes, I work under artificial light in the OR and I couldn’t stand it when my glasses fogged up. So yes, I wanted to be spectacle free for work.

Which IOLs did your ophthalmologist tell you about, and which ones did you consider implanting?

He told me about monovision with a toric IOL, we also spoke about segment multifocal IOLs as far as remember. I was asked about the light conditions I work in, and if I drive a lot at night. As I wanted to be able to read in a restaurant (and because my husband usually drives at night) he said something about pupil independency and the pro and cons. I don’t remember what else we talked about.

What information was available to help you make your choice of IOL?

I asked him for his experiences and other patients. He showed me some simulations on the computer and an image comparing the lens to a juvenile eye. He also showed me that for some other multifocal IOLs. At the end he showed and explained to me what halos and glare are.

Were any IOLs specifically unavailable for you because of the anatomy of your eyes?

He told me sometimes they can put in a combination of two different IOLs that have a different near focus, but then he said that it wouldn’t work because of my level of astigmatism.

Was cost a consideration?

I’ve had glasses all my life. The costs were mounting up and I just wanted rid of them.

How confident were you of a good outcome?

To be honest, I was a bit scared after seeing some scare stories on the Internet – there doesn’t seem to be much good written about the lenses. But I trusted the doctor.

Multifocal IOLs do carry a small risk of ocular side effects (like halo and glare). How did you evaluate the pros and cons (benefits and drawbacks) and what was it that led you to your final decision, to implant a trifocal IOL?

As I had problems with monovision contact lenses in the past, that wasn’t an option. He showed me charts of different multifocal IOLs and images of a halo and glare simulator. I also liked this segment multifocal IOLs he spoke about. But when we compared the juvenile lens to the multifocal IOLs on the charts, I wanted the best results and didn’t really care about the halo and glare thing.

Now that the IOL has been implanted…
What assessments were performed afterwards to see if the lens worked as it should?

The first eye was great. They took the patch off and straight away I could see. They made me read at distance, on the computer and at near. The second eye… I couldn’t see that well the first day, so I was worried. But at the second visit, three days later, it was a great feeling for me when I realized that I could see far better with both eyes than I could do with one eye.

They called me in again for three hours of testing, three months after the surgery. I had to read on charts and a computer in various distances and they made lots of measurements. But I felt confident. At the end I saw the doctor and he asked: “Are you happy?” and I said “Oh yes, I am.” Then he said that my results are great and that is what I thought too. I told him a bit about the halos and glare I see, but that it doesn’t bother me and then I was done.

What difference has this made to the quality of your daily life?

I don’t know if anyone can imagine how it feels to wake up and not see. Everything is blurry. At home, you know everything by heart. But when you are somewhere unfamiliar, like at a friend’s house or at a hotel, you have to look for your glasses like a blind person. For me those times are over. I wake up and I can see my husband beside me and everything else. It was weird not having to look for my glasses. That feeling passed quickly, and was really happy.

What has it helped you to do (and see) more easily?

It made my life simpler. I don’t need glasses anymore. And it is just more comfortable.

Do you still need spectacles for any task?

No, not at all.

Would you recommend having a trifocal IOL implanted to your friends or family?

I already have.