Comparative Analysis Of Visual Quality After Three Kinds Of Multifocal Intraocular Lens Implantation

ObjectiveTo evaluate the clinical value of multiple focal Intraocular Lens by observing the objective and subjective visual quality of diffraction double focus Intraocular Lens(I OL),regional refraction IOL and three trifocal IOL after IOL implantation.MethodsA retrospective case-control study was adopted.Sixty-eight patients(80 eyes)receiving phacoemulsification combined with IOL implantation in our hospital were selected and divided into three groups.Group A received combined diffraction IOL(Tecnis ZMB00,Johnson&Johnson Vision)implantation in 20 patients(26 eyes).Group B received combined regional refraction MIOL(Lentis Mplus LS-313 MF30,Oculentis)implantation in 25 patients(28 eyes);Group C received combined trifocal IOL(AT Lisa Tri839MP,Zeiss)implantation in 23 patients(26 eyes).3 months after surgery,the patients were examined and compared with the uncorrected distance acuity(UDVA),corrected distance acuity(CDVA),and uncorrected intermediate visual acuity of the eye after surgery at 80 cm(UIVA),and uncorrected near visual acuity of the eye after surgery at 40 cm or 33 cm(UNVA),defocus curve,Modulation Transfer Function(MTF),Stahl ratio(SR),High order Aberration(HOA),Aberration,spherical Aberration,clover Aberration and subjective evaluation of patients were investigated by the NEI-VFQ-25.SPSS 23.0 statistical software was used for statistical analysis.Measurement data in this study were expressed as mean± standard deviation(x± S),gender was tested by chi-square test,age,postoperative visual acuities,wavefront aberrations,SR values,MTF values and questionnaire were all tested by non-parametric Kruskal-Wallis rank sum test.P<0.05 was considered statistically significant.Results2weeks、1 month and 3 months after surgery,there was no significant difference in UDVA,CDVA and UNVA among the three groups(P=0.353、0.261、0.985;0.290、0.202、0.943;0.371、0.375、0.939).The UIVA of group C was better than that of group A and B,and the difference was statistically significant(P=0.000>0.028;0.000、0.032、0.000、0.029).UIVA in group B was better than that in group A,and the difference was statistically significant(P=0.005、0.006、0.008).There were no significant differences in MTF at 5,10,15,20,25 and 30c/d frequencies in the dark room among the three groups((P>0.05).There was no statistical significance in HOA、clover and SR among the three groups under natural dark light(P=0.885、0.608、0.859;0.878、0.767、0.857、0.874、0.710、0.779).Comet difference between group A and group C was less than that of group B,and the difference was statistically significant(P=0.042、0.012;0.020、0.04;0.042、0.027).Spherical aberration in group A and C was less than that in group B,and the difference was statistically significant(P=0/029、0.023;0.042、0.004;0.013、0.023).There was no statistically significant difference in commotion and spherical aberration between group A and C(P=0.674、0.936;0.639、0.459;0.879、0.851).There were no statistically significant differences in visual clarity,far vision,near vision,distance judgment ability,fine work,glare and halo,night driving,clinical symptoms,daily activities,mental state,and satisfaction among the three groups(P=0.825、0.998、0.927、0.635、0.914、0.737、0.743、0.304、0.986、0.825、0.089).The visual acuity of group B and group C was better than that of group A,and the difference was statistically significant(P=0.000、0.000).The visual acuity difference between group B and group C was not statistically significant(P=0.804).The detachment rate of group B and group C was better than that of group A,and the difference was statistically significant(P=0.019、0.022).There was no statistical significance between group B and group C in the rate of detachment(P=1.000)The total scores of group B and group C were better than that of group A,and the difference was statistically significant(P=0.000、0.000).There was no statistically significant difference in total scores between group B and group C(P=1.000).In group A,3 cases(11.5%)had glare and halo at night,in group B,5 cases(17.9%)had glare and halo at night,in group C,5 cases(19.2%)had glare and halo at night.The detachment rate of group A was 65.4%,group B was 92.9%,and group C was 92.3%.ConclusionAll three types of multifocal IOL provide patients with good distant and near vision.Trifocal IOL provides better mid-range vision compared to regional refraction IOL and bifocal IOL,regional refraction IOL also provides better mid-range vision compared to bifocal IOL,higher order aberrations similar to trifocal IOL and bifocal IOL,smaller commotion and spherical aberrations compared to regional refraction IOL,and trifocal IOL and regional refraction IOL have better mid-range vision and higher detachment rate compared to bifocal IOL.