Reading Between the Lines

An accurate and critical appraisal of scientific studies on simultaneous vision IOLs (SVIOLs) contributes to the best possible outcome for cataract and refractive surgery patients, stresses Filomena Ribeiro MD, PhD. 

In recent years, simultaneous vision IOL technology has been evolving rapidly, resulting in an increase in published research and clinical studies. However, the quality of evidence is not always consistent, Professor Ribeiro observed.

“Rather than simply looking at the conclusions, we need to understand how the study was designed, how outcomes were measured and reported, and how much confidence we can place in the evidence,” she stressed, as unfortunately some studies may be affected by bias or poor methodology.

These are not marginal concerns. A study with a small sample size, a short follow-up period, a flawed or inaccurate methodology, or an inconsistent definition of outcomes can lead to conclusions that, while appearing promising on paper, do not necessarily stand up in daily practice. 

The ability to read studies critically should not be the exclusive preserve of clinical researchers, Prof Ribeiro said. Cataract and refractive surgeons, fellows, and any others involved in patient care should have the practical tools to judge whether published results are reliable enough to influence everyday clinical practice. The ability to identify good findings and trustworthy evidence leads to better treatment for patients, especially when choosing the best lens for them. 

There is also a need for a better understanding of standardised classifications to translate research into clinical decision making. The increasing number of studies on SVIOLs introduces a large number of new technologies and terminologies that may be confusing. 

Prof Ribeiro noted there has been a definite improvement in the quality and consistency of IOL research, but there is still room for further progress. One of the Society’s key contributions in this regard is the ESCRS Simultaneous Vision IOL Classification system, an important milestone that provides ophthalmologists with a scientifically based framework of standardised terminology that also supports more consistent reporting across future studies.

Scientific research is conducted primarily to provide patients with an ever-increasing range of therapeutic and surgical options. Failing to read it critically, or stopping merely at the abstract and conclusions, risks negative consequences for patient care. Congresses, meetings, and scientific societies’ guidelines, Prof Ribeiro said, are there to help people learn these skills and to know which instruments and tools are in place to support them. 

Research on SVIOLs will continue to grow. What also needs to grow is the responsibility of clinicians to keep refining their abilities to select the most appropriate lens and give their patients the best possible outcome, Prof Ribeiro concluded. 

“Ultimately, better critical appraisal leads to better clinical decisions, and better clinical decisions lead to better outcomes for our patients.” 

Filomena Ribeiro MD, PhD, FEBO is head of ophthalmology at Hospital da Luz, Lisbon, Portugal, and the immediate past president of ESCRS.