Development of a near activity visual questionnaire to assess accommodating intraocular lenses☆
Section snippets
Methods
A full and extensive review of existing VR-QOL questionnaires was carried out to identify all questions (items) relating to near vision tasks. Review papers focussing predominantly on questionnaires that assess visual impairment and rehabilitation were used as a starting point [23], [24] but other questionnaires that assess outcomes of cataract/CLE surgery, (with multifocal and accommodating IOL implantation), visual satisfaction and visual ability were also included. Activities were not
Analysis
The questionnaire responses were analysed by Rasch Analysis, which is a form of Item Response Theory (IRT). Details of Rasch Analysis and item response theory (IRT) are discussed elsewhere [27], [28], [29], [30], [31], [32], including its benefits over classical test theory (CTT) [33], [34], but the primary objective is to identify and eliminate redundant items, which is important to minimise respondent burden and implementation time. Previously validated instruments including the QIRC
Results
Rasch analysis was first used to assess the function of each category of the response scales. Table 2a shows that there was an unused response option on the scale for items 1–15 inclusive, as well as another response option that failed to meet the fit statistics. Table 2b shows that the scale for items 16–18 had a response option that failed to meet the fit statistics. As a result, the scales were reduced by first eliminating the response option ‘Stopped due to other reasons’ for items 1–15
Discussion
The purpose of this pilot study was to determine the feasibility of a new VR-QOL instrument to subjectively assess near visual function with ‘accommodating’ IOLs. Questionnaires are an increasingly important and a popular means of assessing outcomes of treatment in many health-related fields, as they provide rapid acquisition of QOL information in real-world settings [58] and are a more appropriate way of assessing outcomes and benefits as opposed to assessing the rate of mortality or morbidity
References (66)
- et al.
Comparison of 6-month results of implantation of the 1CU accommodative intraocular lens with conventional intraocular lenses
Ophthalmology
(2004) - et al.
Early visual results with the 1CU accommodating intraocular lens
J Cataract Refract Surg
(2005) - et al.
Visual properties of the foldable array multifocal intraocular lens
J Cataract Refract Surg
(1996) - et al.
Correction of presbyopia with refractive multifocal phakic intraocular lenses
J Cataract Refract Surg
(2004) - et al.
Near vision restoration with refractive lens exchange and pseudoaccommodating and multifocal refractive and diffractive intraocular lenses: comparative clinical study
J Cataract Refract Surg
(2004) Functional vision after cataract removal with multifocal and accommodating intraocular lens implantation: prospective comparative evaluation of Array multifocal and 1CU accommodating lenses
J Cataract Refract Surg
(2004)- et al.
Presbyopia correction with an anterior chamber phakic multifocal intraocular lens
Ophthalmology
(2005) - et al.
Visual function assessment questionnaires
Surv Ophthalmol
(2001) - et al.
Evaluation of the NEI visual functioning questionnaire as an interval measure of visual ability in low vision
Vis Res
(2001) - et al.
The refractive status and vision profile: evaluation of psychometric properties and comparison of Rasch and summated Likert-scaling
Vis Res
(2006)
Basics of research (Part 14). Survey research methodology: designing the survey instrument
Air Med J
A comparison of two time intervals for test–retest reliability of health status instruments
J Clin Epidemiol
Psychometric properties of the national eye institute-refractive error quality of life instrument
Ophthalmology
Qualitative research in functional vision
Int Ophthalmol Clin
Measuring behaviours and perceptions: Rasch analysis as a tool for rehabilitation research
J Rehabil Med
Visual performance of a multi-zone bifocal and a progressive multifocal contact lens
Clao J
Clinical performance of an innovative back surface multifocal contact lens in correcting presbyopia
Clao J
Fellow eye comparison between the 1CU accommodative intraocular lens and the Acrysof MA30 monofocal intraocular lens
Am J Ophthalmol
Subjective and objective performance of the Lenstec KH-3500 “accommodative” intraocular lens
Br J Ophthalmol
Experience with ARRAY multifocal lenses in a Singapore population
Singapore Med J
Refractive lens exchange with an array multifocal intraocular lens
J Refract Surg
Clear-lens extraction with multifocal lens implantation
Int Ophthalmol Clin
Bilateral implantation of asymmetrical diffractive multifocal intraocular lenses
Arch Ophthalmol
Patient satisfaction after implantation of diffractive designed multifocal intraocular lenses in dependence on objective parameters
Graefes Arch Clin Exp Ophthalmol
The VF-14. An index of functional impairment in patients with cataract
Arch Ophthalmol
Effectiveness of multifocal intraocular lenses to correct presbyopia after cataract surgery: a randomized controlled trial
Ophthalmology
Development of the ‘Activities of Daily Vision Scale’. A measure of visual functional status
Med Care
The quality of life impact of refractive correction (QIRC) questionnaire: development and validation
Optom Vis Sci
Psychometric properties of vision-related quality of life questionnaires: a systematic review
Ophthalmic Physiol Opt
A technique for the measurement of attitudes
Arch Psychol
Choice of response scale for health measurement: comparison of 4,5 and 7-point scales and visual analog scale
J Epidemiol
A systems model for low vision rehabilitation. II. Measurement of vision disabilities
Optom Vis Sci
The measurement of vision disability
Optom Vis Sci
Cited by (16)
Presbyopic LASIK using hybrid bi-aspheric micro-monovision ablation profile for presbyopic corneal treatments
2015, American Journal of OphthalmologyCitation Excerpt :The questionnaire is valid for use with spectacle wearers, contact lens wearers, and those having had laser refractive surgery, intraocular refractive surgery, or eye disease including cataract.16–18 The Near Activity Visual Questionnaire was used to assess patient satisfaction with near functional vision.19 For both questionnaires the raw response scores were converted to a 0–100 Rasch scale, with higher scores indicating worse quality of vision.
Development of a questionnaire to assess the relative subjective benefits of presbyopia correction
2012, Journal of Cataract and Refractive SurgeryCitation Excerpt :The poorest fitting items were removed one at a time and the statistics recalculated after item removal. Removal of items continued until all the items fitted the statistics.19 Assessment of internal consistency was determined using the Cronbach α coefficient.
2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management
2024, Optometry and Vision ScienceSpherical aberrations and their role in modern ophthalmology
2023, Clinical and Experimental OptometryImprovement in near vision following silodosin treatment in patients with lower urinary tract symptoms
2021, International Neurourology Journal
- ☆
This paper was presented as a free paper at the 13th Annual Congress of the British Society for Refractive Surgery on 1–2 July 2006, Oxford UK, and at the XXIV Congress of the European Society of Cataract and Refractive Surgeons on 9–13 September 2006, London UK.