Clinical Observation On Visual Quality After Combined Bilateral Implantation Of Extended Depth Of Focus And Multifocal Intraocular Lenses In Cataract Patients

Purposes:To observe the visual quality of cataract patients after combined bilateral implantation of extended depth of focus intraocular lens(ZXR00)and multifocal intraocular lens(ZMB00),and to evaluate its clinical effect.Methods:A retrospective non-randomized study was conducted to collect patients who underwent bilateral cataract surgery in the Second Affiliated Hospital of Nanchang University from September 2021 to May 2022,and the patients and their families were informed according to their own conditions.Combined bilateral implantation of ZXR00 intraocular lens and ZMB00 intraocular lens was performed in the XM group(17 cases),and bilateral implantation of ZMB00 intraocular lens was performed in the MM group(19 cases).Three months after operation,visual acuity(expressed as log MAR)was collected in one eye and both eyes at distance(5 m),middle(80 cm)and near(33 cm).Defocus curves were plotted for both eyes;CSV-1000 E glare contrast sensitivity tester was used to measure binocular contrast sensitivity,and the contrast sensitivity was compared at spatial frequencies of 3 c/d,6 c/d,12 c/d and 18c/d in photopic,scotopic,photopic conditions with glare and scotopic with glare backgrounds.Patients were instructed to fill out the postoperative visual function scale VF-14 for postoperative assessment.The postoperative spectacle independence was recorded.Results:1.Monocular vision:Three months after surgery,there was no significant difference in uncorrected distance visual acuity(UCDVA)between the dominant and non-dominant eyes in the XM group and the dominant and non-dominant eyes in the MM group(P > 0.05).The uncorrected intermediate visual acuity(UCIVA)of the dominant eye in the XM group was better than that of the non-dominant eye in the XM group,the dominant eye and the non-dominant eye in the MM group,and the difference was statistically significant(P < 0.001).The uncorrected near visual acuity(UCNVA)of the dominant eye in the XM group was worse than that of the non-dominant eye in the XM group and the dominant and non-dominant eyes in the MM group,and the difference was statistically significant(P < 0.001).2.Binocular vision:Three months after surgery,there was no significant difference in UCDVA between the XM group and the MM group in both eyes(P > 0.05).UCIVA was better in the XM group than in the MM group,and the difference was statistically significant(P < 0.001).There was no significant difference in UCNVA between the XM group and the MM group in both eyes(P > 0.05).3.Binocular defocus curve:Three months after surgery,the defocus curves showed a bimodal pattern in both groups.The first peak was located at 0 D(+ 0.5 D to-0.5D)in both groups,and the difference was not statistically significant(P > 0.05).The second peak was located at-3D(-2.5D to-3.5D)in both groups,and the difference was not statistically significant(P > 0.05).The curve between the two peaks was smoother in the XM group than in the MM group.The visual acuity of the XM group was better than that of the MM group at-1.5 D(80 cm)(P < 0.05).4.Contrast sensitivity(CS):There was no significant difference in CS between the two groups at spatial frequencies of 3 c/d,6 c/d and 12 c/d in photopic and photopic conditions with glare background(P > 0.05).At 18 c/d,the XM group was superior to the MM group,and the difference was statistically significant(P < 0.001).The XM group was superior to the MM group at each spatial frequency in scotopic and scotopic conditions with glare backgrounds,and the difference was statistically significant(P < 0.001).5.Visual function questionnaire(VF-14)The score of XM group was 50.76 ± 0.90,which was higher than that of MM group 46.96 ± 1.39,and the difference was statistically significant(P < 0.001).6.Postoperative spectacle independence:Sixteen(94.12%)of the 17 patients in the XM group did not require glasses after surgery in any case.Seventeen of 19 patients(89.47%)in the MM group did not require glasses postoperatively.There was no significant difference between the two groups(P > 0.05).Conclusion:Combined binocular implantation of deep field extended intraocular lens and multifocal intraocular lens can provide better postoperative full range vision and improve the postoperative visual quality of patients.It is one of the programs to optimize postoperative visual quality in patients undergoing binocular cataract surgery.