Assessment of the Impact of Cataract Surgery on Subjective Quality of Vision Across Different Intraocular Lens Type Using the Portuguese-Validated QoV Questionnaire

Background Investigating cataract surgery outcomes is essential to capture patients subjective perception of visual quality. This study evaluated quality of vision (QoV) before and after cataract surgery by comparing different intraocular lens (IOL) models using a Rasch-validated Brazilian Portuguese version of the QoV questionnaire. Methods This prospective study recruited patients from the Cataract Department of the Hospital Oftalmológico de Brasília. Participants were ≥ 50 years old, underwent bilateral phacoemulsification with implantation of the same IOL model, and had preoperative best-corrected visual acuity of 20/50 or better. Included IOLs were monofocal, premium monofocal, extended depth of focus (EDOF), and multifocal lenses. The Rasch-validated QoV questionnaire was administered pre- and postoperatively. Results Fifty-eight patients were analyzed: 10% received EDOF, 18% monofocal, and 70% trifocal IOLs (p < 0.001). Mean age was 64.53 years. For the whole cohort, median satisfaction with uncorrected distance vision increased from 7.50 preoperatively to 8.00 postoperatively (p = 0.002). Median near-vision satisfaction improved from 3.50 to 8.00 (p < 0.001). Median uncorrected visual acuity improved from 0.40 to 0.00 logMAR in both eyes (p < 0.001). In the monofocal group, QoV frequency scores decreased from 35.48 to 21.36 (p = 0.047) and severity scores from 33.87 to 16.99 (p = 0.019), indicating fewer symptoms. Linear mixed-effects models comparing frequency, severity, and bothersome domains among three IOL categories across time and interactions showed no significant differences. Conclusions Cataract surgery improved visual acuity and patient-reported outcomes overall. The monofocal group showed more favorable QoV frequency and severity scores compared with other IOLs, while between-group differences in mixed-model analyses were not statistically significant overall.