| Purpose:To compare the visual quality,visual function and postoperative satisfaction in patients with high myopia cataract after phacoemulsification combined with implanted ZEISS AT LISA 809 M diffractive aspherical multifocal intraocular lens and ZEISS CT ASPHINA 603 P monofocal intraocular lens.Methods:This trial collected 41 patients(41 eyes)with high myopia(26≤AL≤30mm)cataract who underwent phacoemulsification and IOL implantation in hospital from September 2020 to May 2021.Depending on patients demands,20 patients(20 eyes)implanted with ZEISS AT LISA 809 M MIOL as experimental group(group A),21patients(21 eyes)implanted with ZEISS CT ASPHINA 603 P IOL(reserved power-3.00D)as the control group(group B).Uncorrected and best corrected distance visual acuity(5m),uncorrected and distance-corrected intermediate visual acuity(66cm),uncorrected and distance-corrected near visual acuity(40cm)between the two groups at 3 months,6 months after surgery were compared.The defocus curve of two groups were depitcted at 3 months after surgery.Using CSV-1000 E glare contrast sensitivity instrument to detect photopic,mesopic,bright glare(45LX)and dark glare(30LX)contrast sensitivity at different spatial frequencies(3、6、12、18c/d)of two groups.At 6 months after surgery,using OPD Scan Ⅲ to measure intraocular aberrations(total higher-order aberration,spherical aberration,coma aberration,trefoil aberration).IND-VFQ-CN-33 scale was used to investigate patients’ spectacle independence,postoperative satisfaction.Results:1.Visual outcome: Comparison of preoperative and postoperative visual acuity:The UCDVA before operation in group A was 0.63±0.15,and in group B was 0.68±0.15;the UCDVA at 3 months after operation in group A was 0.09±0.06,and in group B was0.41±0.07.The postoperative UCDVA were better than preoperative UCDVA,and the differences were statistically significant(all p<0.001).Distance visual acuity: The UCDVA at 3 months and 6 months after operation in group A were 0.09±0.06 and 0.08±0.07 respectively,in group B were 0.41±0.07 and0.40±0.07 respectively;The BCDVA at 3 months and 6 months after operation in group A were 0.07±0.06,0.04±0.08 respectively,in group B were 0.06±0.09,0.05±0.08 respectively.It was showed that the UCDVA in group A was better than that in group B at each follow-up time,and the differences were statistically significant(all p<0.001).There was no significant difference in BCDVA between the two groups at 3 and 6months after operation(all p>0.05).There was no significant difference in UCDVA and BCDVA between group A and B at 3 months and 6 months after operation(all p>0.05).Intermediate distance visual acuity: The UCIVA at 3 months and 6 months after operation in group A were 0.36±0.10 and 0.35±0.10 respectively,in group B were0.51±0.11 and 0.49±0.10 respectively;The DCIVA at 3 months and 6 months after operation in group A were 0.35±0.09 and 0.35±0.11 respectively,in group B were0.38±0.09 and 0.36±0.07 respectively.It was showed that the UCIVA in group A was better than that in group B at each follow-up time,and the differences were statistically significant(all p<0.001).There was no significant difference in DCIVA between the two groups at 3 and 6 months after operation(all p>0.05).There was no significant difference in UCIVA and DCIVA between groups A and B at 3 months and 6 months after operation(all p>0.05).Near visual acuity: The UCNVA at 3 months and 6 months after operation in group A were 0.12±0.07 and 0.08±0.08 respectively,in group B were 0.64±0.11 and0.59±0.12 respectively;The DCNVA at 3 months and 6 months after operation in group A were 0.11±0.08 and 0.10±0.07 respectively,in group B were 0.74±0.17 and0.73±0.16 respectively.It was observed that the UCNVA and DCNVA in group A were better than that in group B at each follow-up time,and the differences were statistically significant(all p<0.001).There was no significant difference in UCNVA and DCNVA between groups A and B at 3 months and 6 months after operation(all p>0.05).2.At 3 months after surgery,there were no differences of the mean contrast sensitivity at spatial frequency under(3,6,and 12c/d)in photopic,mesopic,bright glare(45LX)and dark glare(30LX)in group A and B(all p>0.05).The mean contrast sensitivity at spatial frequency under 18 cpd in photopic,mesopic,bright glare(45LX)and dark glare(30LX)in group A were 0.82±0.26 、0.92±0.16、0.75±0.19、0.64±0.16 respectively,in group B were 1.33±0.21 、1.20±0.23、1.05±0.19、1.01±0.34 respectively;comparing the mean contrast sensitivity at spatial frequency under 18 cpd in different condition,the group A were lower than that of group B,and the differences were statistically significant(all p<0.001).3.The defocus curves of the two groups after 3 months after surgery showed that the group A had obvious double peaks with peaks at 0.00 D and-3.00 D respectively,while the group B showed a single peak with a peak at 0.00D;At 0.00 D,the visual acuity in group A was 0.08±0.12,in group B was 0.09±0.11;at-1.50 D(66 cm),in group A was 0.37±0.11,in group B was 0.43±0.08;at-3.00D(33 cm),in group A was 0.09±0.12,in group B was 0.69±0.16.The visual acuity between the two groups at 0.00 D and-1.5D(66 cm)(p > 0.05)were found no difference,but visual acuity between the two groups at-3.0 D(33 cm)was found significantly differences(p<0.001),implying a better performance regarding the near vision in the experimental group.4.At 6 months after surgery,the RMS of intraocular higher-order aberrations,coma aberrations,trefoil aberrations in group A were higher than group B with a pupil diameter of 3mm and 5mm,and the differences were statistically significant(all p<0.001),while the spherical-like aberration was not statistically significant(p>0.05).The intraocular higher-order aberrations,coma aberrations,trefoil aberrations and spherical-like aberration in two groups of patients with a pupil diameter of 5mm were higher than those with a pupil diameter of 3mm,and the differences were statistically significant(all p<0.001).5.The total score of the group A was 41.05±2.43 at 6 months after surgery,and the total score of the group B was 42.05±2.45,we found no significant difference between the two groups(p>0.05).Group A had greater independence from spectacle of near vision(80.00%)than Group B(19.05%),and the difference was statistically significant(p<0.05).The main postoperative visual disturbances were glare and halo at night,there were 2 cases in Group A appear halo symptom and 1 case in Group B appear glare symptom,all of which appeared in the early stage.Conclusion:1.High myopia with cataract can effectively improve vision acuity after phacoem-ulsification combined with implanted ZEISS AT LISA 809 M multifocal IOL or ZEISS CT ASPHINA 603 P monofocal IOL,but ZEISS AT LISA 809 M MIOL can provide better near vision and meets the demands of patients for spectacle independence than monofocal intraocular lens.2.Although ZEISS AT LISA 809 M multifocal IOL develop lower contrast sensitivity under 18 cpd in photopic,mesopic,bright glare(45LX)and dark glare(30LX)than ZEISS CT ASPHINA 603 P monofocal intraocular lens,and increased intraocular HOA,it has no effect on patients’ daily life. |
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