Angle Kappa is Not Correlated with Patient-Reported Outcomes After Multifocal Lens Implantation.

PURPOSE: To examine the effect of preoperative angle kappa on patient-reported outcomes after multifocal lens placement during cataract surgery and determine if it is an effective measure for preoperative patients screening for multifocal lens placement.

SETTING: Private refractive surgery clinics.

DESIGN: Retrospective cohort study.

METHODS: All patients undergoing bilateral cataract or refractive lens exchange surgery with a target of emmetropia between 2013 and 2017 at Optical Express (Glasgow, UK) with multifocal lens placement for whom preoperative angle kappa measurement and a postoperative month 1 patient-reported outcomes measures were available were included.

RESULTS: A total of 1368 patients were identified. Median preoperative angle kappa was 0.41mm with an interquartile range of 0.30mm to 0.53mm. Preoperative angle kappa did not have a significant association with patient-reported satisfaction with vision (correlation coefficient 0.15, 95% confidence interval -0.081 to 0.39, P = 0.20) nor with patient-reported photic phenomena ( P > 0.09 for all comparisons). A receiver-operator characteristic analysis did not yield a viable cutoff predictive of patient-reported satisfaction.

CONCLUSION: Angle kappa was not predictive of patient-reported satisfaction in this study. This study did not find evidence that it should be used as a screening test for patients considering multifocal intraocular lens placement.