Clinical Observation On Visual Quality In Patients Implanted With Two Different Types Of Multifocal Intraocular Lenses

Purpose:We evaluate and compare the visual quality in patients implanted with asymmetric refractive rotationally asymmetric multifocal intraocular lenses(MIOL)SBL-3 and diffractive MIOL Tecnis ZMB00.Methods:Retrospective paired controlled study was used.Sixty cataract eyes in 32 patients were included.Patients underwent phacoemulsification and intraocular lens(IOL)implantation in our hospital from December 2020 to December 2022.They received regional refractive MIOL(SBL-3)or diffractive MIOL(ZMB00)implantation.And the follo up period was 12 months.The mean of uncorrected distance visual acuity(UCDVA)and best corrected distance visual acuity(BCDVA)at 5m,uncorrected intermediate visual acuity(UCIVA)at 80 cm and uncorrected near visual acuity(UCNVA)at 40 cm were compared between the two groups preoperatively and postoperatively on 1 month,3 months and 6 months.The defocus curve was performed after operation 3 months.Photopic and mesopic contrast sensitivity test with or without glare were taken by CSV-1000 E instrument.The total intraocular higher-order aberration(HOA),spherical aberration(SA),coma aberration(CA),and trefoil aberration(TA)were recorded with OPD Scan Ⅲ at pupil diameters of 3 mm and 5 mm respectively.Patients’ satisfaction were assessed by VF-14 questionnaire.We recorded spectacle independence of the patients,the number of patients with glare and halo phenomena from the first day to 6 months after surgery.And we observed the incidence of posterior capsular opacification(PCO)within 12 months after surgery in all patients.Results:1.Visual outcome:At 6 months after surgery,UCDVA in both groups was significantly better than that before surgery,and the differences were statistically significant(P<0.001);There were no statistically significant differences in UCDVA,BCDVA,UCIVA,and UCNVA between the two groups at 1,3 and 6 months after surgery(P>0.05).2.At 3 months after surgery,the defocus curves of the two groups showed that the peak values of the curve in group A appeared at 0.0D and-2.5D,with a relatively flat trend,while the group B presented a significant double peaks,with the first peak at 0.00 D and the second peak at-3.0D,The curve trend was relatively steep,and the curve decreased significantly after the peak.3.At 3 months after surgery,The CS values of the four spatial frequencies(3,6,12,18 c /d)in group A were higher than those of group B under dark vision,bright glare and dark glare conditions,with a statistically significant difference(P<0.05).There was no statistically significant difference between the two groups under the conditions of bright vision(85cd/m2)(P>0.05).4.At 3 months after surgery,when the pupil diameter was 3mm and 5mm,the intraocular HOA,SA,CA and TA in Group A were significantly higher than those in group B(P<0.05);When the pupil diameter was 5mm,the above intraocular parameters in group A and B were higher than those in the 3mm pupil diameter,and they were statistically different(P<0.05).5.At 6 months after surgery,the satisfaction rate was 92.0% in Group A,and94.3% in Group B;The rate of distant spectacles-independent was 100% in both groups,while the rate of near spectacles-independent was 88.0% in Group A and91.4% in Group B;Comparing the number of patients who experience halo and glare after surgery between the two groups,3 patients(12.0%)and 0 patients(0.0%)in Group A experienced glare,7 patients(28.0%)and 2 patients(8.0%)had halo on the first day and 6months respectively,while 5 patients(14.3%)and 1 patients(2.9%)in Group B had glare,7 patients(20.0%)and 2 patients(5.7%)had halo on the first day and 6 months respectively;There was no significant difference between the two groups(P>0.05).6.Within 12 months after surgery,there was 1 patient(4%)in Group A who occurred PCO,while there was no PCO in Group B,with no statistically significant difference(P>0.05).Conclusion:1.Regional refractive asymmetric MIOL SBL-3 and diffractive MIOL Tecnis ZMB00 can both effectively improve the postoperative vision of patients,with high patient satisfaction and high spectacles-independent rate.2.Compared with ZMB00,SBL-3 has higher contrast sensitivity under dark vision,bright glare,and dark glare conditions.However,SBL-3 group has larger intraocular parameters such as high-order aberrations,spherical aberration,coma aberration and trefoil aberration.