Visual performance during night driving after intraocular refractive surgery procedures

Cataracts reduce visual acuity and contrast sensitivity, and increase photic phenomena, especially at night. Recent advancements in cataract surgery have improved intraocular lens (IOL) designs. Monofocal, multifocal, and extended depth-of-focus IOLs offer different vision ranges but can still cause adverse visual effects like reduced contrast sensitivity and photic phenomena, affecting night driving. Investigating how different IOLs affect night driving is crucial for road safety and quality of life.

Studies assessing night driving performance in patients who underwent surgery with monofocal, multifocal, and extended depth-of-focus IOL implantations were included in this review. The following databases were searched to conduct the review: PubMed, Scopus and Web of Science. The level of scientific evidence was graded according to the Scottish Intercollegiate Guidelines Network (SIGN).

Multifocal IOL implantation improves quality of life, however night driving continues to be challenging for some multifocal IOL patients whose neuroadaptation process has not been completed. Therefore, the use of validated questionnaires to adequately assess night driving before and after IOL implantation is highly recommended. Further well-designed randomized clinical trials are needed to objectively assess visual function during night driving. Night driving simulators could provide complementary reliable information to questionnaires' outcomes.