Observation of visual quality after regional multifocal intraocular lens implantation in high myopia with cataract
Objective To observe the early clinical visual quality of patients with high myopia and cataract after implantation of regional multifocal intraocular lens(MIOL),and compare it with single-focus intraocular lens(SIOL)implantation.Method 41 patients(60 eyes)with high myopia and cataract who underwent phacoemulsification combined with intraocular lens implantation surgery in Xi'an People's Hospital from July 2021 to December 2022,and they were divided into two groups.The MIOL group consisted of 22 patients(30 eyes)with regional refractive MIOL implantation,and the SIOL group consisted of 19 patients(30 eyes)with SIOL implantation.The uncorrected distant visual acuity(UDVA),uncorrected near visual acuity(UDNA)and optometry examinations were recorded at 3 months and 6 months after operation,the defocus curve of operation eye was drawn,the high order aberration,coma,trefoil and spherical aberration of the whole eye after operation were measured by OPD-Scan type III refractive power/corneal analyzer;the tilt of IOL in the capsule pocket was represented by the value of Tilt(S1);Modulation transfer function cutoff frequency(MTF cutoff)and objective scattering index(OSI)were measured by OQAS objective visual quality analysis system.Result UDVA and UNVA of 60 eyes in MIOL group and SIOL group at 3 m and 6 m after surgery were significantly better than those before surgery,UDVA and UNVA in MIOL group were better than those in SIOL group,with statistical significance difference(P＜0.01).The postoperative diopter of small pupil optometry in MIOL group was between+0.25 D and-0.50 D,the SIOL group was between-1.50 D and-3.00 D,and the patients could not remove the glasses after surgery.The average defocus curve at 3 months after operation showed there were two peaks at 0.0 D and-2.5 D in MIOL group,and formed a wide plateau between 0.0 D and-2.5 D.Higher order aberration,coma and trefoil in the MIOL group was higher than that in the SIOL group,with statistical significance difference(P＜0.01).But spherical aberration was not statistically significant between the two groups(P＞0.01).MTF cutoff after surgery was significantly higher than before surgery,OSI was significantly lower than before surgery,the difference was statistically significant(P＜0.01),but there was no statistically significant difference between the two groups(P＞0.01).At 3 months after surgery,Tilt(S1)values of both groups were within the normal range under the pupil of 6 mm,and there was no significant difference between the two groups(P＞0.01).Conclusion Compared with SIOL implantation,regional refraction MIOL implantation can provide better and more stable overall vision and visual quality,a higher post operative glass removal rate,a lower optical interference,and a better early capsular stability for patients with high myopia comb cataract.
High myopiaCataractRegional multifocal intraocular lensVisual quality
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