Comparison And Analysis Of Visual Quality After Three Kinds Of Multifocal Intraocular Lens Implantation

Objective:To compare the postoperative subjective and objective visual quality of three kinds of Multifocal Intraocular Lens(MIOL)after implantation of phacoemulsification in this study,and to evaluate the clinical effect and application value of these.Methods:It was a case-control study enrolled cataract patients who underwent phacoemulsification and AT LISA tri839MP,SBL-3 and AcrySof(?)IQ ReSTOR(?)+3.0D implantation at our hospital between May 2017 to January 2018.They were divided into three groups based on the MIOL type,Trifocal Intraocular Lenses group,SBL-3 group and ReSTOR+3D group.Trifocal Intraocular Lenses groups 9 cases(14 eyes);SBL-3 group 7 cases(11 eyes);ReSTOR group 9 cases(14 eyes).Three months after surgery,the visual quality was observed,the uncorrected distant visual acuity(UCDVA),uncorrected intermediate visual acuity(UCIVA),uncorrected near visual acuity(UCNVA),best-corected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),distant corrected intermediate visual acuity(DCIVA),distant corrected near visual acuity(DCNVA),defocus curve,modulation transfer function(MTF),Strehl Ratio(SR)were recorded and Analysis of subjective visual quality questionnaire.Results:38 of the 39 patients were followed up during the postoperative,IOLs are located in the capsular bag,there were no posterior capsule opacification and other complications.1 patients with SBL-3IOL were inclined to IOL in the postoperative.1.Visual acuity:Three months after operation,there was no significant differences in UDVA,UIVA,BCDVA,BCNVA,DCNVA.(F=2.544,P=0.093;F=0.996,P=0.379;F=1.318,P=0.280;F=0.087,P=0.917;F=2.057,P=0.143).The uncorrected distant visual acuity of Trifocal Intraocular Lenses group,SBL-3 group and ReSTOR+3D group was 0.09 ±1.13,0.27±0.27 and 0.21±0.17 respectively;The uncorrected intermediate visual acuity of Trifocal Intraocular Lenses group,SB L-3 group and ReSTOR+3D group was-0.30±0.00,-0.27±0.09 and-0.26±0.08 respectively;The best corrected distant visual acuity of Trifocal Intraocular Lenses group,SBL-3 group and ReSTOR+3D group was 0.03 ±0.05,0.05± 0.12 and 0.09±0.10 respectively;The best corrected near visual acuity of Trifocal Intraocular Lenses group,SBL-3 group and ReSTOR+3D group was 0.19±0.07,0.18±0.12 and 0.20±0.15 respectively;There was a significant differences in UNVA,DCIVA.The uncorrected near visual acuity,SBL-3 group was higher than Trifocal Intraocular Lenses group higher than ReSTOR+3D group(0.33±0.13 vs 0.39±0.04 vs 0.46±0.13,F=4.605,P=0.017);Three groups were compared pairwise.The difference of SBL-3 group and ReSTOR+3D group was statistically significant(P=0.005).The difference of Trifocal Intraocular Lenses group and SBL-3 group,ReSTOR+3D group was no statistically significant(P=0.184;P=0.086).The distant corrected intermediate visual acuity,Trifocal Intraocular Lenses group was higher than SBL-3 group higher than ReSTOR+3D group(0.14±0.12 vs 0.17±0.08 vs 0.30±0.15,F=6.201,P=0.005).Three groups were compared pairwise.The difference of Trifocal Intraocular Lenses group and ReSTOR+3D group;SBL-3 group and ReSTOR+3D group was statistically significant(P=0.002:P=0.015).The difference of Trifocal Intraocular Lenses group and SBL-3 group was no statistically significant(P=0.555).2.The defocus curve:Three months after operation,the three groups all had peak appeared between 0D(5m)and-2.5D(40cm),and were smoother.At 0D(5m),the Trifocal Intraocular Lenses group higher than that of SBL-3 group and ReSTOR+3D group.At-ID(lm),namely the middle distance,the Trifocal Intraocular Lenses group was higher than the SBL-3 group and the ReSTOR+3D group.At-3D(33cm)namely the near distance,SBL-3 group was higher than Trifocal Intraocular Lenses group and ReSTOR+3D group.3.Visual quality:Three months after operation,the modulation transfer function in objective visual quality of Trifocal Intraocular Lenses group,SBL-3 group and ReSTOR+3D group was 32.529±17.325,29.972±16.819 and 19.829±13.960 respectively,the difference was not statistically significant(F=2.414,P=0.104).Strehl Ratio(SR),the Trifocal Intraocular Lenses group was higher than the SBL-3 group higher than the ReSTOR+3D group,the differences was statistically significant(F=4.239,P=0.022).Three groups were compared pairwise.The difference of Trifocal Intraocular Lenses group and SBL-3 group,ReSTOR+3D group was statistically significant(P=0.026;P=0.000).The difference of SBL-3 group and ReSTOR+3D group was no statistically significant(P=0.069).In the questionnaire the Trifocal Intraocular Lenses group and the SBL-3 group had 100%spectacle dependence rate,two patients in the ReSTOR+3D group needed glasses.One patient in SBL-3 group had glare at night,and one patient in ReSTOR+3D group had halo.Conclusions:1.Three kinds of MIOL can obtain better full range vision and patient satisfaction.The uncorrected near visual acuity,the SBL-3 group vision was higher than the other two groups.The distant corrected intermediate visual acuity,the Trifocal Intraocular Lenses group vison was higher than the other two groups.From the defocus curve,the Trifocal Intraocular Lenses group and the SBL-3 group are better than the ReSTOR+3D group in the whole vision.3.Considering the particularity design of MIOL,the stability of MIOL in capsular bag is still worth our attention.