OPD-Scan Ⅲ Evaluates The Effect Of CTR On MFIOL Centering,Tilt And Visual Quality In Cataract Patients With High Myopia After Surgery

Purpose:The effect of intraoperative implantation of capsular bag tension rings(CTR)on postoperative centrality and tilt of multifocal IOLs in patients with high myopic cataract was observed with the OPD-Scan Ⅲ instrument,as well as their effect on postoperative visual quality.Methods:In this study,48 patients(48 eyes)with high myopic cataract who were implanted with multifocal IOLs at the Second Affiliated Hospital of Nanchang University from January 2022 to June 2022 were included in the experiment.All patients who were included in the experiment were divided into two groups,A and B.Twenty-two patients(22 eyes)in group A were in the experimental group,the patients in group A underwent cataract phacoemulsification + multifocal IOL implantation +capsular tension ring implantation,while 26 patients(26 eyes)in group B were enrolled in the control group,and patients underwent cataract phacoemulsification +multifocal IOL implantation.The postoperative uncorrected distance visual acuity(5m)and corrected distance visual acuity(5m)were compared between the two groups at 3 and 6 months postoperatively.The postoperative decentration of the MFIOL was measured using OPD-Scan Ⅲ at pupil diameters of 4mm and 6mm to reflect the centrality of the IOL,and the tilt and total intraocular higher-order aberration,spherical aberration,coma and trefoil aberration at the corresponding pupil diameters were measured too.The quality of postoperative vision-related survival was assessed using the IND-VFQ-CN-33 visual function scale at 6 months postoperatively.The postoperative data of both groups were statistically analyzed using IBM SPSS Statistics 26.0 statistical software.Results:1.postoperative decentration of the MFIOL: the decentration of the MFIOL were 0.16 ± 0.02 mm and 0.22 ± 0.04 mm at 3 months and 6 months postoperatively in group A.the decentration of the MFIOL were 0.21 ± 0.03 mm and 0.27 ± 0.04 mm at 3 months and 6 months postoperatively in group B,respectively.The differences in the decentration of MFIOL between the two groups were statistically significant at the 3-month and 6-month postoperative follow-ups(P < 0.001).The eccentric displacement of the MFIOL was positively correlated with the axial length at each postoperative follow-up time point in both groups(P<0.001).2.Postoperative tilt of the MFIOL: the tilt of the MFIOL at 3 months and 6months after surgery in group A were 0.57±0.06 μm and 0.75±0.06 μm,respectively.the tilt of the MFIOL at 3 months and 6 months after surgery in group B were0.71±0.11 μm and 0.93±0.05 μm,respectively.The differences between the two groups were statistically significant(P < 0.001).The differences at both follow-up time points in the tilt of MFIOL between the two groups were statistically significant(p < 0.001).There was no correlation between the tilt of intraocular lens and the axial length at each follow-up time point in the two groups(P>0.05).3.Preoperative and postoperative visual acuity: The preoperative uncorrected distant visual acuity(UDVA)was 0.71±0.15 in group A,and the postoperative UDVA was 0.06±0.1 and 0.12±0.12 at 3 and 6 months,respectively.group A patients had a preoperative corrected distant visual acuity(CDVA)of 0.85±0.28,and postoperative CDVA of-0.01±0.10 and-0.01±0.10 at 3 and 6 months,respectively.The preoperative UDVA was 0.70±0.12 in group B,and the postoperative UDVA was0.01±0.10 and 0.06±0.14 at 3 and 6 months,respectively.Preoperative CDVA was0.82±0.31,and postoperative CDVA was-0.01±0.11 and-0.02±0.11 at 3 and 6months,respectively,for patients in group B.Postoperative UDVA and CDVA were significantly better than preoperative ones in both groups(P < 0.001),and there was no significant difference in UDVA and CDVA between the two groups at the two postoperative follow-up time points(P > 0.05).4.Postoperative higher-order aberrations: The total intraocular higher-order aberrations,spherical aberration,coma aberrations,and trilobal aberration of patients in group A and group B at 6 months postoperatively were higher than those at 4 mm pupil diameter,and the difference was statistically significant(P < 0.001).The differences in total intraocular higher-order aberration,spherical aberration,coma aberration,and trilobal aberration between the two groups were not statistically significant(P > 0.05)for pupil diameters of 4 mm and 6 mm.5.postoperative patients IND-VFQ-CN-33 scale assessment: patients in both groups were assessed on the IND-VFQ-CN-33 scale at the 6-month postoperative follow-up.the total scale scores of patients in groups A and B at the follow-up time points were 38.136 ± 2.997 and 39.654±3.762,respectively,with no statistically significant differences(P>0.05).Conclusions:1.The position of the intraocular lens(IOL)may change after surgery in patients with high myopic cataract,and the centering of the IOL after surgery are correlated with the axial length.2.Cataract surgery in patients with high myopic cataracts can result in improved visual acuity and good visual quality.The combined implantation of a multifocal IOL and a capsular tension ring during cataract surgery can help center the IOL and reduce tilt after surgery.