Clinical Observation Of Regional Refractive Multifocal Intraocular Lens For Postoperative Visual Quality Of Patients With Axial Myopia And Cataract

Purpose:Iin this paper,we compare regional refraction MIOL SBL-3 with single focus intraocular lens HOYA in axial myopia patients Complete the role of far,middle,and near vision tasks and two kinds of intraocular lens in the visual quality of the Contrastive study between subjective and objective,to explore postoperative the axial myopia with cataract patients those who have nearly requirements,the practical application of multifocal intraocular lens and single focal intraocular lens,to provide a theoretical basis for the selection of intraocular lens in patients with axial myopia combined with cataract.Methods:This study was a retrospective,non-randomized,clinical case-control study.Patients with axial myopia(24≤AL≤28mm)who selected for cataract phacoemulsification combined with artificial lens implantation in our hospital from October 2019 to September 2020 were collected.Multifocal intraocular lenses(SBL-3)and single focal intraocular lens(HOYA)were implanted according to the actual needs of patients.Patients implanted with regional refraction MIOL SBL-3 were in group A,and patients implanted with aspheric intraocular lens HOYA(the reserved diopter is-3.0D)were in group B.Slit lamp examination and fundus examination,noncontact tonometer intraocular pressure measurement were performed 3 and 6 months after surgery,using the standard logarithmic distant acuity chart,to 5m distance check uncorrected distance visual acuity,best corrected distance visual acuity,using Colenbrander Mixed Contrast Card Set visual acuity test card check uncorrected intermediate visual acuity(66 cm)uncorrected near visual acuity(40 cm),distancecorrected intermediate visualacuity(66 cm)and distance-corrected near visualacuity(40 cm).Six months after surgery,the CSV-1000 E glare contrast sensitivity instrument was used to detect the contrast sensitivity of the operative eyes.The inspection distance was 2.5m,and the contrast sensitivity of different spatial frequencies(3,6,12,18 C /d)under bright vision,dark vision,bright glare(45LX)and dark glare(30LX)was examined.Subjective visual function after 6 months scale(VF-14)questionnaire survey,using the OPD Scan Ⅲ measuring operative eyes when the Pupil diameter of3 mm and 5 mm intraocular aberrations(total higher-order aberrations,spherical-like aberration,coma aberration,trefoil aberration).Results:1.UCDVA in group A was better than group B at 3 months and 6 months,and the differences were statistically significant(P < 0.001),while BCDVA had no statistical significance(P > 0.05).There was no statistical significance in UCDVA and BCDVA between two groups comparison within each group at 3 months and 6 months after surgery(P > 0.05).2.UCIVA in group A was better than group B at 3 and 6 months,and the differences were statistically significant(P < 0.001),while DCIVA had no statistical significance(P > 0.05).There was no statistical significance in UCIVA and DCIVA between the two groups comparison within each group at 3 months and 6 months after surgery(P > 0.05).3.There were statistically significant differences in UCNVA and DCNVA at 3 and6 months after surgery between the two groups(P < 0.05),and the difference of DCNVA was statistically significant(P < 0.001).There was no statistical significance in UCNVA and DCNVA between the two groups comparison within each group at 3months and 6 months after surgery(P > 0.05).4.At 6 months after surgery,the highest CS in the operative eyes of the two groups were compared under different spatial frequencies(3,6,12,18 C /d)of bright vision,dark vision,bright glare(45LX)and dark glare(30LX),and the differences were statistically significant(P > 0.05).5.Six months after surgery,when the pupil diameter was 3mm,the intraocular total higher-order aberrations(t.HOA),coma aberration(T.C),trefoil aberration(T.T)were statistically significant(P < 0.001),while spherical-like aberration(T.S)was not statistically significant(P > 0.05).When the pupil diameter was 5mm,the intraocular total higher-order aberrations(t.HOA),trefoil aberration(T.T)were statistically significant(P < 0.001),while spherical-like aberration(T.S)and coma aberration(T.C)were not statistically significant(P > 0.05).When the pupil diameter was 3mm to 5mm,the intraocular total higher-order aberrations(t.HOA),spherical-like aberration(T.S),coma aberration(T.C),trefoil aberration(T.T)were compared within each group at 6 months after surgery,the change was statistically significant(P < 0.001).6.There was no statistical significance in the total score of VF-14 between the two groups 6 months after surgery(P > 0.05).Conclusion:1.Implanting SBL-3 in patients with axial myopia can achieve good full-course vision and better meet the needs of patients for spectacle independence.However,patients with axial myopia still need to wear glasses when SIOL is implanted for longdistance and middle-distance work.Especially in patients with SBL-3 implantation,UCNVA and DCNVA are better than SIOL.2.The contrast sensitivity of SBL-3 in patients with axial myopia is better than that of SIOL.3.By comparing the high-order aberrations of the implanted SBL-3 and HOYA under different pupil diameters,it shows that the day and night imaging quality of SBL-3 is worse than that of SIOL.