The Clinical Study Of The Visual Quality After Capsular Bag Implantation Of Aspheric Multifocal Intraocular Lens(SN6AD1)

Objective:To investigate the clinical effectiveness of implantation of multifocal intraocular lens, the mechanism of off-center of the lens post-implantation of multifocal intraocular lens and the protective measure for off-center.Methods:In this randomized clinical test,36cases of age-related cataract patients were divided into2groups at random, with18patients in each group respectively, i.e. multifocal intraocular lens group (MIOL), implanted24piece of multifocal intraocular lens, and monofocal intraocular lens group (SIOL), implanted28piece of monofocal intraocular lens. Within2to4month after implantation of intraocular lens, the visual acuity of each pseudophakic eye was examined, including uncorrected distance vision acuity, uncorrected near visual acuity, best corrected distance visual acuity, best corrected near visual acuity, distance corrected near visual acuity, intermedial distance visual acuity (100cm), contrast visual acuity, and depth of focus. The eccentric status of the intraocular lens, the changes of the sac in which the intraocular lens was implanted, and the performance of the loop of intraocular lens were also examined. In addition, each patient would perform a questionnaire on adverse visual symptoms, reading spectacles rate and their satisfaction on the intraocular lens.Results:3months after the implantation of intraocular lens, there was no significant difference in uncorrected distance vision acuity, best corrected distance visual acuity and best corrected near visual acuity between MIOL group and SIOL group (P>0.05), but the uncorrected near visual acuity, the best corrected near visual acuity of the MIOL group patient was superior than that of SIOL group (P<0.05). The focal depth of the MIOL group patients was superior to that of the SIOL group patients (4.50D vs1.88D, P<0.05). In the corrected distance visual acuity of contrast visual acuity, there were no remarkable difference between these two group patients when the contract was100%,25%and5%, but when the contract was100%, the corrected distance visual acuity of the MIOL group patients was inferior to that of the SIOL group patients. In the intermedial distance visual acuity, there were14eyes (58.3%) whose height-low contrast was less to3lines (the height-low contrast of normal visual acuity person was about3lines). In the MIOL group, there were21eyes (87.5%) that can read8pt Chinese Charaeter when the contract was100%, and there were12eyes (50%) that can read8pt Chinese Charaeter when the contract was10%(the Chinese Charaeter in newspaper and journal is about8pt, the higher the character number, the bigger the style of calligraphy). When the contract was100%, the distance corrected best visual acuity of the MIOL group patients was obviously superior to that of the SIOL group patients (0.093±0.171vs0.541±0.169, P<0.05), and when the contract was10%, the distance corrected best visual acuity of the MIOL group patients was better than that of the SIOL group patients (0.467±0.169vs0.739±0.159, P>0.05)(all were logMAR visual acuity). There were6patients whose off-center was superior to0.5mm, with3patients whose off-center was superior to1mm in the MIOL group, and there were8patients whose off-center was superior to0.5mm, within2to4month after implantation of intraocular lens. It was displayed in the questionnaire that patients with off-center of the lens presented dysfunction of visual sense, and some patients can not clearly see distance or near. The glare was the major sign of dysfunction of visual sense, with no significant difference between MIOL group and SIOL group (P>0.05). The reading spectacles rate of the patients in MIOL group was lower than that in SIOL group (P<0.05).Conclusions:SN6AD1multifocal intraocular lens can offer favorabl e wholerange visual acuity for mostly patients with age-related cataract,1ower the dependenceon presbyopia glasses, and increase the quality of vi sual sense of the age-related cataract patients post implantation of pseudo phakic eye. With the clinical application ofmultifocal intraocular lens, it was payed close attention to the adverse effect ofMIOL, i.e. fuzzy, off-ce nter of the lens, et al. The latest multifocal intraocularlens (SN6AD1MIOL) presented lower off-center rate, but the off-center of th e multifocal intraocular lens will result in more severe sign of dysfunctio n of visual sense and obfuscation when seeing distance or near than that o f the monofocal intraocular lensSo the indication for multifocal intraocula r lens should be payed close attention. Ensure tearing the sac continuousl y and completely, absorbing the cortex of lens thoroughly in the implanta tion of off-center of the lens were the key factor to prevent the occurrence of off-center of the lens. Key words:multifocal intraocular lens (MIOL), monofocal intraocular lens group (SIOL), off-center of the lens, quality of vision.