Comparison Of Postoperative Visual Performance Between Trifocal Functional Intraocular Lens And Monofocal Aspheric Intraocular Lens

OBJECTIVE: To evaluate the visual acuity and visual quality of trifocal functional intraocular lens(aspherical diffractive type)and monofocal aspheric intraocular lens after implantation.Methods: A total of 91 eligible cataract patients(138 eyes)were selected and divided into two groups.Group A: Trifocal functional intraocular lens(Zeiss AT LISA tri 839MP)was implanted intraoperatively,a total of 42 cases(65 eyes),including 19 females(34 eyes),and 23 males(31 eyes).Group B: Monofocal aspheric intraocular lens(Akreos Mi60)was implanted intraoperatively,a total of 49 cases(73 eyes),including 25 females(38 eyes),24 males(35 eyes).Three months after the operation,uncorrected distant vision(UCDVA),uncorrected intermediate vision(UCIVA),uncorrected near vision(UCNVA),best corrected distant vision(BCNVA),best corrected near vision(BCNVA),contrast sensitivity,defocusing curve and the area under the curve were recorded in each group.Patients’ postoperative satisfaction,spectacle independence and visual function were investigated by questionnaire.Results: At 3 months after operation,there were statistically significant differences in UCDVA,UCIVA and UCNVA between group A and group B(p <0.001,0.001,0.006);there was no statistically significant difference in BCNVA,BCNVA between group A and group B(p = 0.109,0.288).The contrast sensitivity curve of group B was generally higher than that of group A.The differences between group A and group B are statistically significant when the spatial frequency were 3 cpd,6 cpd,12 cpd,18 cpd,and the P values are <0.001,<0.001,<0.001,0.018.At a spatial frequency of 1.5 weeks / degree,the difference between the two groups was not statistically significant(P = 0.415).It can be found from the defocusing curve that group A had better intermediate vision and nearer vision,and group A had a wider range of vision than group B.The area graph under the curve had a statistically significant difference between group A and group B at distant distance,intermediate vision and nearer vision,with P values of 0.002,0.033,and 0.021,respectively.The score of VF-14 scale in group A was 6.29 ± 1.62,and that in group B was 16.14 ± 4.39.The score of VF-14 scale between the two groups was statistically significant,and the P value was <0.001.Only one patient in group B stated that he was very dissatisfied with the vision recovery after the operation,meanwhile the most of the other patients expressed satisfaction with vision recovery after the operation.At distant distance,intermediate vision and nearer vision,there were statistical differences between group A and group B,and P values were 0.001,<0.001,and <0.001,respectively.In terms of overall satisfaction,there was a statistical difference between group A and group B,with P value of <0.001.Group A had higher spectacle independence than group B at distant distance,intermediate vision and nearer vision,which were 90.3%,93.5% and 93.5% respectively,and that of group B had 40.9%,31.8% and 18.2% respectively.There was no significant difference in postoperative visual interference between patients in each group.Conclusion: Compared with monofocal aspheric intraocular lens,trifocal functional intraocular lens could provide a full range of clear vision for the majority of patients with simple cataracts,improve the rate of spectacle independence and patients’ satisfaction.Theoretically,the trifocal functional intraocular lens would reduce the patients’ contrast sensitivity and even cause visual impairment such as glare and abnormal color vision compared with the monofocal aspheric intraocular lens,but it would not significantly affect the daily life of the patients.