The Happy Patient Project was started with the goal to develop a preoperative patient questionnaire, which enables the surgeon to identify patients who are suitable for multifocal lenses. The hypothesis was that eligibility of patients is not only determined by their ocular conditions but also by their personality. Active members of the Happy Patient Project Group who contributed patient data were — besides me — Dr Ulrich Mester, (Saarbruecken), Dr Werner Hütz, (Bad Hersfeld), Dr Thomas Neuhann, (Munich), Dr Stefanie Schmickler, (Ahaus), Dr Peter Szurman, (Sulzbach/Saar) and Dr Thomas Vaterrodt, (Saarbruecken), all from Germany.

Assessing patient personality

First step of the Happy Patient Project was to identify correlations between patient personality and postoperative patient satisfaction. Psychometric parameters were used to assess patient personality.

Figure 1: Distribution of implanted multifocal IOL models.

In this prospective multicentred project 183 patients with bilateral implantation of multifocal lenses were enroled. Postoperative data could be gained from 163 patients after 3 months and 139 patients after 6 months. Choice of the multifocal lens was at the discretion of the surgeon, as well as surgical technique and medication.

Figure 2: Visual acuity pre- and postoperatively (BCVA = best-corrected distance visual acuity; UCDVA = uncorrected distance visual acuity; UCNVA = uncorrected near visual acuity).

Preoperatively, patients had to fill in a psychometric questionnaire including parts of the NEO PI-R Personality Inventory and the Compulsiveness Inventory. This included questions on patient's degree of competence, tidiness, sense of duty, ambition, self-discipline and deliberateness. Patients were also asked about their visual expectations.

Figure 3: Patient feedback on frequency of spectacle use for near, intermediate and far distance vision.

Pre-op, surgical and post-op clinical data were recorded in web-based documentation forms, provided by a grant from Abbott Medical Optics. Two follow-up visits were scheduled 3 months and 6 months after surgery. Patients underwent routine eye examinations and filled in a questionnaire evaluating their use of spectacles for near, intermediate and far distance activities, performance of daily activities under different light conditions and overall satisfaction.

A variety of multifocal IOLs were used, including Tecnis ZM900/ZMA00 (AMO), ReZoom (AMO), Acri.Lisa (Carl Zeiss Meditec) and ReSTOR/Restor+3 (Alcon). Overall, near and distance visual acuity results were excellent with mean uncorrected distance visual acuity of 0.05 logMAR after 3 months and 0.06 logMAR after 6 months. Mean best-corrected visual acuity was 0.03 log MAR after 3 months and 0.02 logMAR after 6 months.