Spectacle Independence After Premium Intraocular Lens Implantation: Outcomes at Lagos University Teaching Hospital

Premium intraocular lenses (IOLs), including multifocal and extended depth-of-focus lenses, offer cataract surgery patients the prospect of spectacle independence, but their real-world outcomes in the context of Nigerian ophthalmology practice have not been systematically evaluated. This study assesses spectacle independence and patient satisfaction following premium IOL implantation at Lagos University Teaching Hospital (LUTH), South West Nigeria. A prospective cohort study will be conducted among 80 eyes of patients undergoing bilateral cataract surgery with multifocal or extended depth-of-focus IOL implantation at LUTH over 12 months. Visual acuity outcomes at distance, intermediate, and near will be measured using standardised charts. Spectacle independence will be assessed at six months using the Patient-Reported Spectacle Independence Questionnaire. Patient satisfaction, dysphotopsia symptoms, and residual refractive error will also be recorded. Bilateral sequential surgery and outcomes of both eyes will be analysed using mixed-effects models. Premium IOL implantation is a growing service offered in Nigerian private and some teaching hospitals, driven by increasing patient expectations. However, results depend critically on meticulous pre-operative biometry, patient selection excluding corneal irregularity and macular pathology, and surgeon experience. LUTH provides an important real-world setting for premium IOL evaluation given its diverse patient demographic and range of surgeon experience levels. Findings will guide patient counselling protocols and IOL selection criteria at LUTH. Recommendations will include structured pre-operative assessment pathways and outcome benchmarking against international standards. Keywords: premium intraocular lens, multifocal IOL, spectacle independence, cataract surgery, LUTH Lagos