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Outcomes in randomised controlled trials of multifocal lenses in cataract surgery: the case for development of a core outcome set
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    Should the minimum data set be expanded further?
    • Elizabeth M Law, Optometrist Southend University Hospital, BMI Southend Hospital
    • Other Contributors:
      • Rajesh K Aggarwal, Consultant Ophthalmic Surgeon
      • Phillip Buckhurst, Optometrist
      • Hetal Buckhurst, Optometrist

    We read with interest the recent article by Evans et al regarding outcomes in randomised control trial of multifocal lenses in cataract surgery, and their case for development of a core outcome set.1 We wholeheartedly agree that a set of core outcomes would be hugely beneficial to multifocal intraocular lens (MIOL) studies, as there is such variation in multifocal studies currently. This has been commented on by previous Cochrane reviews2 yet there remains no consensus. Such variability makes meaningful comparison between studies difficult.
    Evans’ suggests that the minimum data collected in MIOL studies should be unaided and corrected distance and near LogMAR acuity and contrast sensitivity. Also, the use of a questionnaire for patient reported outcomes that must include questions relating to spectacle independence and halos/glare.
    Whilst we agree with the above measures, we feel that perhaps such a minimum data set may be insufficient particularly as it fails to address intermediate vision. We would recommend the inclusion of a defocus profile that covers distance, intermediate and near ranges. In addition, a standardised method of defocus measurement3 and analysis.4 This could be used as an adjunct to conventional visual acuity testing or indeed as a replacement. MIOLs have different add powers and light distribution profiles; consequently the choice of testing distance for near and intermediate acuity measures has a profound impact on results and hence may n...

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    Conflict of Interest:
    None declared.