The Effect of Psychological Intervention on the Visual Quality of Patients with a Diffractive Multifocal Intraocular Lens Implant

Abstract

Objective This study aimed to investigate the effect of psychological intervention on the visual quality of patients with a diffractive multifocal intraocular lens implant and its possible mechanism.

Methods Eighty-nine patients undergoing age-related cataract surgery were enrolled in the study at the Affiliated Hospital of Southwest Medical University between December 2015 and July 2017. They were randomly divided into two groups: multiple focus M1 group (n = 45) and multiple focus M2 group (n = 40). The M1 group was only given routine preoperative health education, treatment, and evaluation, while the M2 group also received psychological intervention.

Results After treatment, there was no statistical difference in the uncorrected distance and near visual acuity, corrected distance and near visual acuity, or the vision and near removal rate in either of the two groups (p > 0.05). However, postoperative glare was lower in the M2 group (p < 0.05), and patient satisfaction was higher in the M2 group (p < 0.05). The M2 group had a more obvious improvement in the Symptom Checklist-90 score (p < 0.05), the serum interleukin-6 (IL-6) was lower, and the serum brain-derived neurotrophic factor (BDNF) was higher in the M2 group (p < 0.05). In addition, serum IL-6 had a negative correlation with the depression score, and serum BDNF also showed a negative correlation with the anxiety score (p < 0.05).

Conclusions Psychological intervention improved the stress state of patients with age-related cataracts and diffractive multifocal intraocular lens implants, reduced the level of inflammatory factors in the body, improved the level of BDNF, reduced postoperative visual interference, and improved postoperative satisfaction.

Zusammenfassung

Ziel Diese Studie untersuchte die Auswirkung einer psychologischen Intervention auf die Sehqualität von Patienten mit einem diffraktiven multifokalen Intraokularlinsenimplantat und deren möglichen Mechanismus.

Methoden Neunundachtzig Patienten, die sich einer altersbedingten Kataraktoperation unterzogen, wurden zwischen Dezember 2015 und Juli 2017 in die Studie am Affiliated Hospital der Southwest Medical University aufgenommen. Sie wurden nach dem Zufallsprinzip in 2 Gruppen eingeteilt: die M1-Gruppe (n = 45) und die M2-Gruppe (n = 40) mit Mehrfachfokus. Die M1-Gruppe erhielt nur eine routinemäßige präoperative Gesundheitserziehung, Behandlung und Bewertung, während die M2-Gruppe auch eine psychologische Intervention erhielt.

Ergebnisse Nach der Behandlung gab es in keiner der beiden Gruppen einen statistischen Unterschied in der unkorrigierten Fern- und Nahsehschärfe, der korrigierten Fern- und Nahsehschärfe oder der Seh- und Nahentfernungsrate (p > 0,05). Allerdings war die postoperative Blendung in der M2-Gruppe geringer (p < 0,05), und die Patientenzufriedenheit war in der M2-Gruppe höher (p < 0,05). Die M2-Gruppe wies eine deutlichere Verbesserung des Symptom-Checklist-90-Scores auf (p < 0,05), das Serum-Interleukin-6 (IL-6) war niedriger und der Serum-BDNF (brain-derived neurotrophic factor) war in der M2-Gruppe höher (p < 0,05). Darüber hinaus bestand eine negative Korrelation zwischen dem Serum-IL-6 und dem Depressions-Score, und der Serum-BDNF zeigte ebenfalls eine negative Korrelation mit dem Angst-Score (p < 0,05).

Schlussfolgerungen Die psychologische Intervention verbesserte den Stresszustand von Patienten mit altersbedingter Katarakt und diffraktiven multifokalen Intraokularlinsenimplantaten, verringerte den Gehalt an entzündlichen Faktoren im Körper, verbesserte den BDNF-Spiegel, verringerte die postoperativen Sehstörungen und verbesserte die postoperative Zufriedenheit.

Key words

pediatric ophthalmology - physiological optics - glaucoma

Schlüsselwörter

okuläre Tumoren - physiologische Optik - Glaukom

Publication History

Received: 09 January 2022

Accepted: 05 October 2022

Accepted Manuscript online:
10 October 2022

Article published online:
16 February 2023

• References

• 1 Song P, Wang H, Theodoratou E. et al. The national and subnational prevalence of cataract and cataract blindness in China: a systematic review and meta-analysis. J Glob Health 2018; 8: 010804
• 2 Davis G. The Evolution of Cataract Surgery. Mo Med 2016; 113: 58-62
• 3 Breyer DRH, Kaymak H, Ax T. et al. Multifocal Intraocular Lenses and Extended Depth of Focus Intraocular Lenses. Asia Pac J Ophthalmol (Phila) 2017; 6: 339-349
• 4 Buckhurst PJ, Wolffsohn JS, Naroo SA. et al. Multifocal intraocular lens differentiation using defocus curves. Invest Ophthalmol Vis Sci 2012; 53: 3920-3926
• 5 Mester U, Vaterrodt T, Goes F. et al. Impact of personality characteristics on patient satisfaction after multifocal intraocular lens implantation: results from the “happy patient study”. J Refract Surg 2014; 30: 674-678
• 6 Jin Y, Zabriskie N, Olson RJ. Dysphotopsia outcomes analysis of two truncated acrylic 6.0-mm intraocular optic lenses. Ophthalmologica 2009; 223: 47-51
• 7 de Silva SR, Evans JR, Kirthi V. et al. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2016; (12) CD003169
• 8 Kim KH, Kim WS. Visual Outcome and Patient Satisfaction of Low-Power-Added Multifocal Intraocular Lens. Eye Contact Lens 2018; 44: 60-67
• 9 McGwin jr. G, Li J, McNeal S. et al. The impact of cataract surgery on depression among older adults. Ophthalmic Epidemiol 2003; 10: 303-313
• 10 Wong TY. Effect of increasing age on cataract surgery outcomes in very elderly patients. BMJ 2001; 322: 1104-1106
• 11 Clark SM, Sand J, Francis TC. et al. Immune status influences fear and anxiety responses in mice after acute stress exposure. Brain Behav Immun 2014; 38: 192-201
• 12 Morris CE, Winchester LJ, Jackson AJ. et al. Effect of a simulated tactical occupation task on physiological strain index, stress and inflammation. Int J Occup Saf Ergon 2020; 26: 204-209
• 13 Meuleners LB, Hendrie D, Fraser ML. et al. The impact of first eye cataract surgery on mental health contacts for depression and/or anxiety: a population-based study using linked data. Acta Ophthalmol 2013; 91: e445-e449
• 14 Miranda M, Morici JF, Zanoni MB. et al. Brain-Derived Neurotrophic Factor: A Key Molecule for Memory in the Healthy and the Pathological Brain. Front Cell Neurosci 2019; 13: 363
• 15 Ibrahim AM, Chauhan L, Bhardwaj A. et al. Brain-Derived Neurotropic Factor in Neurodegenerative Disorders. Biomedicines 2022; 10: 1143
• 16 Ting EY, Yang AC, Tsai SJ. Role of Interleukin-6 in Depressive Disorder. Int J Mol Sci 2020; 21: 2194
• 17 Roohi E, Jaafari N, Hashemian F. On inflammatory hypothesis of depression: what is the role of IL-6 in the middle of the chaos?. J Neuroinflammation 2021; 18: 45
• 18 Burr H, Formazin M, Pohrt A. Methodological and conceptual issues regarding occupational psychosocial coronary heart disease epidemiology. Scand J Work Environ Health 2016; 42: 251-255