Vision Quality Analysis Of Spherical Aberration After Aspherical Intraocular Lens Implantation

PART Ⅰ VISUAL QUALITY ANALYSIS OF ASPHERICAL INTRAOCULAR LENS IMPLANTATION BASED ON CATQUEST-9SF SCALEObjective:Based on the Chinese version of the Catquest-9SF scale,the contrast sensitivity meter and wavefront aberrometer were used to evaluate the visual quality of cataract patients implanted with three different spherical aberrations.Method:Retrospective study.Patients who have the lens implantation in our department from January 2016 to may 2018 were enrolled.145 patients were screened according to the exclusion criteria,including 51 patients in the SOFTEC HD group and 42 patients in the ZCB00 group.a total of 52 cases in HQ.all patients underwent naked eye vision,best corrected visual acuity and slit lamp microscope,high-order aberrations of the eyes and contrast sensitivity test.the Catquest-9SF scale was used to score the postoperative visual satisfaction of the patients.Results: After the aspherical spherical aberration type intraocular lens implantation,the scale score was the highest,the aspherical negative spherical aberration intraocular lens scale score was the middle,the spherical intraocular lens scale score was the lowest,and the scores of the three groups were the same.Statistical differences.The total residual spheroid difference in the highest score group was in the range of(0.06616-0.08772)μm.The contrast sensitivity of the spherical group of artificial crystals in the space without glare and glare was lower than that of the aspherical group,and the difference was statistically significant(p<0.05).In the aspheric group,there was no glare and glare.,low spatial frequency(3c/d,6c/d)contrast sensitivity,aspherical negative spherical aberration type intraocular lens is higher than aspherical spherical aberration type intraocular lens;high spatial frequency(12c/d,18c/d)The contrast sensitivity,aspherical negative spherical aberration type intraocular lens is higher than aspheric negative spherical aberration type intraocular lens.Conclusion: the total spherical residual spherical aberration of cataract patients after implantation of intraocular lens is in the range of 0.06616-0.08772 um.the cataquest 9sf scale has the highest score and the postoperative visual quality is better.Part Ⅱ CORRELATION BETWEEN CORNEAL SPHERICAL ABERRATION AND AXIAL LENGTH AND CORNEAL CURVATURE IN AGE-RELATED CATARACTObjective: To measure the preoperative spherical aberration and corneal curvature in patients with cataract by PENTACAM AXL,and to analyze its correlation with age,axial length and corneal curvature,and to guide clinical cataract surgery compared with traditional IOL MASTER(VERSION 5.4.3)instruments.Optimization of IOL and recovery of postoperative visual quality.Method: Observational study.All patients with senile cataract who were admitted to the Department of Ophthalmology of the Sixth People’s Hospital of Shanghai Jiaotong University from November 20 to January 2019 were included in the exclusion criteria.All patients underwent visual acuity,IOL master,and Pentacam AXL.Linear regression was used to analyze the relationship between age,axial length and corneal sphericity and corneal curvature.The BLAND-ALTMAN chart was used to analyze the consistency of the measurement results of the two inspection devices.Results: Age was significantly positively correlated with spherical aberration on the posterior corneal surface.The length of the axial length was significantly positively correlated with the curvature of the anterior surface of the cornea and was significantly negatively correlated with the curvature of the posterior surface of the cornea.The curvature of the anterior surface of the cornea was significantly positively correlated with the spherical aberration of the anterior surface of the cornea and the total spherical aberration of the cornea.The curvature of the posterior surface of the cornea was negatively correlated with the spherical aberration of the posterior surface of the cornea.The flatness axis K1 and the axial axis of the anterior corneal surface obtained by the two instruments were in good agreement.Conclusion: Pentacam AXL and traditional IOL master(version5.4.3)instruments have good consistency in measuring the flat axis K1 and axial length of the anterior surface of the cornea,and the consistency of the measurement parameters of the residual cornea is poor,which cannot be replaced in clinical application.Part Ⅲ Clinical observation of TORIC intraocular lens correction for age-related cataract with corneal regular astigmatismObjective: The visual quality of TORIC intraocular lens implantation was evaluated using a contrast sensitivity meter and a visual quality analyzer.Methods: A total of 41 eyes(41 eyes),including 15 males and 26 females,with an average age of 69.41±13.08,were enrolled in our hospital for the treatment of cataract patients with astigmatic corneal regular astigmatism in 2017-2019.year old.All patients underwent Pentacam AXL corneal topography,IOL master,and A/B ultrasonography.The average follow-up time was 6 months.The uncorrected visual acuity,best corrected visual acuity and optometry,contrast sensitivity,high-order aberration of the eye,Pentacam AXL examination,and observation of Toric intraocular lens implantation under slit lamp were performed.Postoperative capsular rotation stability was evaluated to evaluate the effectiveness of Toric IOL in correcting corneal regular astigmatism.Results: There was a statistically significant difference between postoperative total astigmatism and preoperative ocular astigmatism(p<0.001).There was no significant difference between preoperative corneal astigmatism and postoperative corneal astigmatism(p=0.473).There was no significant difference between the pre-estimated residual astigmatism and the actual residual astigmatism after surgery(p=0.066).There was no significant difference in postoperative best corrected visual acuity compared with postoperative naked eye visual acuity(p=0.058).Among the best corrected visual acuity,85% of those with visual acuity of 0.8 or more.The postoperative removal rate was 88%.The total postoperative aberrations and spherical aberration were lower than those before surgery(P<0.001,p<0.001).There was no significant difference between postoperative coma and preoperative coma(p= 0.190).The contrast sensitivity of each spatial frequency under postoperative glare was less than that before surgery,and the difference was statistically significant(p is less than 0.001).The average degree of rotation after intraocular lens surgery was(3.67 ± 1.27)°.The postoperative J0 was lower than that before surgery,and the difference was statistically significant(p=0.003).The postoperative J45 was lower than that before surgery,and the difference was not statistically significant(p=0.883).Conclusion: The implantation of Toric intraocular lens can effectively correct astigmatism in patients with cataract and corneal regular astigmatism,improve the visual acuity of the naked eye and improve the overall visual effect after surgery,and maintain good rotational stability for a long time.