{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T16:53:51Z","timestamp":1777481631077,"version":"3.51.4"},"reference-count":48,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Semmelweis University Central Library"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Phacoemulsification and intraocular lens (IOL) implantation comprise a standard procedure for cataract treatment. However, minimal refractive error remains a determinant of postoperative results. Our study aimed to evaluate the refractive outcomes and the impact of the surgeon\u2019s experience and the IOL model on Kosovan and Hungarian patients after cataract surgery. Methods: This study included the preoperative and postoperative data of 1417 patients scheduled to undergo cataract surgery with IOL implantation at two centers: the Ophthalmology Department of Semmelweis University, Budapest, Hungary, and the Ophthalmology Department of the University Clinical Center of Kosovo, Prishtina, Kosovo. STATA and SPSS were used for statistical analysis. Results: The data of 1001 Hungarian and 416 Kosovan patients were included in this study. There was a statistically significant difference between the groups in the 1-month postoperative best-corrected distance visual acuity (BCDVA) (p = 0.001); in the Hungarian patients, the 1-month BCDVA was 85.2%, while in the Kosovan patients, it was 49.6%. Of the 14 different IOLs implanted in the Hungarian patients, the AcrySof IQ toric SN6AT, FineVision HP (POD F GF), and 677MTY IOLs resulted in a statistically significant positive impact on the 1-month postoperative visual acuity (p &lt; 0.05). The AcrySof SA60AT and Akreos ADAPT AO, implanted in the Kosovan patients, had a statistically significant positive impact on the 1-month postoperative visual acuity (p &lt; 0.05). More extensive surgeon experience had a statistically significant positive impact on postoperative outcomes (p &lt; 0.00). Conclusions: Multifocal and toric IOLs showed superiority in terms of postoperative outcomes in our study; therefore, we conclude that greater surgeon experience, the availability of premium IOLs, and appropriate IOL selection have a considerable impact on refractive outcomes after cataract surgery.<\/jats:p>","DOI":"10.3390\/jcm13237013","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T06:57:54Z","timestamp":1732172274000},"page":"7013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Refractive Outcomes After Cataract Surgery\u2014The Impact of Preoperative Visual Acuity, the Intraocular Lens Model, and the Surgeon\u2019s Experience: An Empirical Analysis of Hungarian and Kosovan Patients"],"prefix":"10.3390","volume":"13","author":[{"given":"Flaka","family":"Shoshi","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"},{"name":"Department of Ophthalmology, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fitore","family":"Shoshi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agim","family":"Xhafa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Clinical Center of Kosovo, 10000 Prishtina, Kosovo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n Zsolt","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"ref_1","first-page":"62","article-title":"Construction of Preoperative Assessment Program for Day Surgery in Geriatric Cataract Patients: An Evidence-Based Delphi Study","volume":"1","author":"Cao","year":"2024","journal-title":"J. PeriAnesthesia Nurs."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990\u20132020: A systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob Health"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Khoramnia, R., Auffarth, G., \u0141abuz, G., Pettit, G., and Suryakumar, R. (2022). Refractive Outcomes after Cataract Surgery. Diagnostics, 12.","DOI":"10.3390\/diagnostics12020243"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4103\/2320-3897.195311","article-title":"Prevention and correction of residual refractive errors after cataract surgery","volume":"5","author":"Ladi","year":"2017","journal-title":"J. Clin. Ophthalmol. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000126085","article-title":"Impact of Low Vision on Well-Being in 10 European Countries","volume":"222","author":"Mojon","year":"2008","journal-title":"Ophthalmologica"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0886-3350(01)01027-6","article-title":"Refractive error and visual outcome after cataract extraction","volume":"28","author":"Murphy","year":"2002","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s40662-014-0002-2","article-title":"Surgical options for correction of refractive error following cataract surgery","volume":"1","author":"Abdelghany","year":"2014","journal-title":"Eye Vis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1016\/j.ophtha.2011.05.038","article-title":"Improving Cataract Surgery Refractive Outcomes","volume":"118","author":"Ladas","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/j.jcrs.2019.06.002","article-title":"Topography and longitudinal chromatic aberration characterizations of refractive\u2013diffractive multifocal intraocular lenses","volume":"45","author":"Loicq","year":"2019","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2060","DOI":"10.1016\/j.jcrs.2011.05.047","article-title":"Design and qualification of a diffractive trifocal optical profile for intraocular lenses","volume":"37","author":"Gatinel","year":"2011","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/ceo.12181","article-title":"Optical performance of two new trifocal intraocular lenses: Through-focus modulation transfer function and influence of pupil size","volume":"42","year":"2014","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4294","DOI":"10.1364\/BOE.8.004294","article-title":"Extended depth of focus intraocular lens. Chromatic performance","volume":"8","author":"Vega","year":"2017","journal-title":"Biomed. Opt. Express"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/archopht.1986.01050160095020","article-title":"Improving the predictability of intraocular lens power calculations","volume":"104","author":"Holladay","year":"1986","journal-title":"Arch. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/j.1600-0420.2006.00774.x","article-title":"Improved accuracy of intraocular lens power calculation with the Zeiss IOLMaster","volume":"85","author":"Olsen","year":"2007","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/S0886-3350(01)00772-6","article-title":"1998 European Cataract Outcome Study: Report from the European Cataract Outcome Study Group","volume":"27","author":"Barry","year":"2001","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1034\/j.1600-0420.2002.800304.x","article-title":"The Swedish National Cataract Register: A 9-year review","volume":"80","author":"Stenevi","year":"2002","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0886-3350(02)01913-2","article-title":"Effect of visual acuity on biometry prediction error after cataract surgery","volume":"29","author":"Daniel","year":"2003","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zhang, C., Dai, G., Pazo, E.E., Xu, L., Wu, X., Zhang, H., Lin, T., and He, W. (2020). Accuracy of intraocular lens calculation formulas in cataract patients with steep corneal curvature. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241630"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s40662-021-00273-z","article-title":"Application of artificial intelligence in cataract management: Current and future directions","volume":"9","author":"Gutierrez","year":"2022","journal-title":"Eye Vis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1136\/bjophthalmol-2020-317822","article-title":"Anterior chamber depth, lens thickness and intraocular lens calculation formula accuracy: Nine formulas comparison","volume":"106","author":"Gil","year":"2022","journal-title":"Br. J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Stopyra, W., Cooke, D.L., and Grzybowski, A. (2024). A Review of Intraocular Lens Power Calculation Formulas Based on Artificial Intelligence. J. Clin. Med., 13.","DOI":"10.3390\/jcm13020498"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ajo.2020.04.035","article-title":"Accuracy of New Generation Intraocular Lens Calculation Formulas in Vitrectomized Eyes","volume":"217","author":"Tan","year":"2020","journal-title":"Am. J. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ajo.2020.09.019","article-title":"Accuracy of Artificial Intelligence Formulas and Axial Length Adjustments for Highly Myopic Eyes","volume":"223","author":"Cheng","year":"2021","journal-title":"Am. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3739","DOI":"10.1007\/s00417-021-05295-w","article-title":"Accuracy of intraocular lens power calculation in primary angle-closure disease: Comparison of 7 formulas","volume":"259","author":"Hou","year":"2021","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1080\/02713683.2021.1933056","article-title":"Clinical Accuracy of 18 IOL Power Formulas in 241 Short Eyes","volume":"46","author":"Voytsekhivskyy","year":"2021","journal-title":"Curr. Eye Res."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Khan, A.M., Waldner, D.M., Luong, M., Sanders, E., Crichton, A.C.S., and Ford, B.A. (2022). Stabilization of refractive error and associated factors following small incision phacoemulsification cataract surgery. BMC Ophthalmol., 22.","DOI":"10.1186\/s12886-021-02221-w"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.jcrs.2017.04.022","article-title":"Resident and young physician experience with complex cataract surgery and new cataract and refractive technology: Results of the ASCRS 2016 Young Eye Surgeons survey","volume":"43","author":"Schallhorn","year":"2017","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4103\/sjopt.sjopt_64_22","article-title":"Analysis of accuracy of twelve intraocular lens power calculation formulas for eyes with axial hyperopia","volume":"37","author":"Stopyra","year":"2023","journal-title":"Saudi J. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100026","DOI":"10.1016\/j.ajoint.2024.100026","article-title":"Comparison of IOL power formulas in eyes with a flat cornea <42 D","volume":"1","author":"Ferrara","year":"2024","journal-title":"AJO Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/j.1442-9071.2007.01452.x","article-title":"Aberration and contrast sensitivity comparison of aspherical and monofocal and multifocal intraocular lens eyes","volume":"35","author":"Zeng","year":"2007","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/j.jcrs.2007.03.052","article-title":"Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses","volume":"33","author":"Vingolo","year":"2007","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.jcrs.2009.10.044","article-title":"Visual function and patient experience after bilateral implantation of toric intraocular lenses","volume":"36","author":"Ahmed","year":"2010","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1016\/j.ophtha.2010.07.033","article-title":"The AcrySof Toric intraocular lens in subjects with cataracts and corneal astigmatism: A randomized, subject-masked, parallel-group, 1-year study","volume":"117","author":"Holland","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.ophtha.2023.10.010","article-title":"Toric Monofocal Intraocular Lenses for the Correction of Astigmatism during Cataract Surgery: A Report by the American Academy of Ophthalmology","volume":"131","author":"Steigleman","year":"2024","journal-title":"Ophthalmology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/j.jcrs.2013.01.037","article-title":"Visual performance of 2 aspheric toric intraocular lenses: Comparative study","volume":"39","author":"Scialdone","year":"2013","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jcrs.2018.11.034","article-title":"Comparison of visual and refractive outcomes between hydrophilic and hydrophobic trifocal intraocular lenses sharing the same optical design","volume":"45","author":"Nagy","year":"2019","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3514577","DOI":"10.1155\/2021\/3514577","article-title":"First Results after Implantation of Hydrophilic and Hydrophobic Trifocal Intraocular Lenses: Visual and Optical Performance","volume":"2021","author":"Poyales","year":"2021","journal-title":"J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3237","DOI":"10.2147\/OPTH.S273641","article-title":"Comparison of Visual Performance and Patient Satisfaction Outcomes with Two Trifocal IOLs with Similar Optical Design but Different Materials","volume":"14","author":"Poyales","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"623","DOI":"10.2147\/OPTH.S403351","article-title":"Long Term Clinical Outcomes of Hydrophilic and Hydrophobic Versions of a Trifocal IOL with the Same Optical Design","volume":"17","author":"Ang","year":"2023","journal-title":"Clin. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/j.jfo.2018.04.011","article-title":"Incidence of posterior capsular opacification requiring Nd:YAG capsulotomy after cataract surgery and implantation of enVista\u00ae MX60 IOL","volume":"41","author":"Tran","year":"2018","journal-title":"J. Fran\u00e7ais D\u2019ophtalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3109\/09286586.2014.903499","article-title":"Outcomes and Barriers to Uptake of Cataract Surgery in Rural Northern China: The Heilongjiang Eye Study","volume":"21","author":"Li","year":"2014","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1016\/j.jcrs.2008.06.036","article-title":"Factors related to the degree of success in achieving target refraction in cataract surgery: Swedish National Cataract Register study","volume":"34","author":"Kugelberg","year":"2008","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1038\/eye.2011.103","article-title":"The cataract national data set electronic multi-centre audit of 55,567 operations: Case-mix adjusted surgeon\u2019s outcomes for posterior capsule rupture","volume":"25","author":"Sparrow","year":"2011","journal-title":"Eye"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ajo.2016.09.003","article-title":"The Auckland Cataract Study: Assessing Preoperative Risk Stratification Systems for Phacoemulsification Surgery in a Teaching Hospital","volume":"171","author":"Kim","year":"2016","journal-title":"Am. J. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1016\/j.jcrs.2009.05.027","article-title":"Capsule complication during cataract surgery: Long-term outcomes: Swedish Capsule Rupture Study Group report 3","volume":"35","author":"Johansson","year":"2009","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1038\/eye.2012.51","article-title":"The Cataract National Dataset electronic multi-centre audit of 55,567 operations: Risk indicators for monocular visual acuity outcomes","volume":"26","author":"Sparrow","year":"2012","journal-title":"Eye"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jcrs.2012.11.026","article-title":"Visual outcome of cataract surgery; Study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery","volume":"39","author":"Barry","year":"2013","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.jcrs.2012.04.025","article-title":"Complication rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital","volume":"38","author":"Haripriya","year":"2012","journal-title":"J. Cataract Refract. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7013\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:36:34Z","timestamp":1760114194000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":48,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13237013"],"URL":"https:\/\/doi.org\/10.3390\/jcm13237013","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]}}}