Analysis Of Postoperative Visual Quality Of Rotationally Asymmetric Multifocal Intraocular Lens Versus Monofocal Intraocular Lens

Purpose To evaluate the medium and long term clinical curative effects of a rotationally asymmetric multifocal intraocular lens(MIOL)SBL-3(Lenstec,Barbados)and a monofocal aspheric intraocular lens Adapt AO(Bausch & Lomb,USA).Methods Forty-three age-related cataract patients(86 eyes)in Anhui Provincial Hospital from August 2019 to June 2020 were enrolled.All of them underwent phacoemulsification cataract surgery and in-the-bag IOL implantation.According to the type of intraocular lens implanted,they were divided into two groups,including 25patients(50 eyes)in the SBL-3 group and 18 patients(36 eyes)in the Adapt AO group.Ophthalmological examinations included uncorrected distance visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA),uncorrected near visual acuity(UNVA),defocus curve,modulation transfer function(MTF),Strehl-ratio(SR)and wavefront aberrations at more than 3 months postoperatively.The visual function index-14 were assessed in all patients.Analyze the correlation between pupil size and optical quality indicators in the SBL-3 group.Results There was no statistically significant difference between groups in postoperative UDVA(P=0.4707).Postoperative UIVA and UNVA were significantly better for the SBL-3 group than for the Adapt AO group(P=0.0009、P<0.0001).Statistically significant differences were revealed in defocus levels from –1.50 D to-4.00 D with better visual acuities for the SBL-3 group.For optical quality outcomes,statistically significant differences between groups were observed in root mean square(RMS)of total high-order aberrations,coma and trefoil,presenting significantly higher values of these parameters in the eyes of the SBL-3 group(p < 0.0001).There was no significant difference in spherical aberration(SA)between the two groups.Statistically significant differences were revealed in the SR values and MTF values at all spatial frequencies between groups(P<0.0001).There were significant differences in scores for the near activities of VF-14(P<0.0001).In the SBL-3 group,Pupil size were negatively correlated with MTF average height values(R=-0.6069,P <0.0001)and SR values(R=-0.7138,P <0.0001),while pupil size were positively correlated with root mean square(RMS)of total high-order aberrations(R=0.6993,P<0.0001).Conclusions A rotationally asymmetric multifocal intraocular lens SBL-3 can provide patients with satisfactory UDVA,UIVA,UNVA and visual quality,and improve the quality of life of patients to a certain extent.Its optical quality is correlated with pupil size.