Comparative Analysis Of Visual Quality After Intraocular Lens Implantation Of Two Different Types Of Functional

Purpose: To compare the clinical efficacy after implantation of extended depth of focus(Tecnis Symfony)intraocular lens and regional refractive multifocal intraocular lens(SBL-3).Methods: This study used a prospective cohort study design.Forty-five eyes of 37 patients with age-related cataracts who underwent phacoemulsification and intraocular lens implantation in the First Affiliated Hospital of Anhui Medical University from March 2022 to October 2022 were enrolled.These patients were divided into two groups according to the different IOLs implanted.Group A included 21 patients(25eyes)implanted with Symfony,and Group B included 16 patients(20 eyes)implanted with SBL-3.All the patients were followed up for 3 months after surgery.The uncorrected distance visual acuity(UCDVA),uncorrected intermediate visual acuity(UCIVA),uncorrected near visual acuity(UCNVA),and best-corrected distance visual acuity(BCDVA)of the two groups were examined at 3 months after surgery.The objective scatter index(OSI),modulation transfer function cutoff(MTF cutoff),Stehr ratio(SR),and predicted visual acuity(PVA)at 100%,20%,9% contrast(OV100%,OV20%,OV9%)were measured by objective quality analysis system(OQAS).The i Trace was used to measure wavefront aberrations,including total aberrations(TA),total low-order aberrations(t LOAs),defocus,astigmatism,total high-order aberrations(t HOAs),spherical,coma,trefoil,and second astigmatism.Visual function index-14(VF-14)was used to evaluate the visual function of the patients,and a questionnaire was used to investigate the rate of spectacle independence,whether there were nighttime optical interference symptoms,and post-operative efficacy satisfaction.IBM SPSS 25.0 statistical software was used to analyze all data,and P < 0.05 was considered statistically significant.Results: 3 months after the operation,the UCDVA,UCIVA,UCNVA,and BCDVA of groups A and B were significantly higher than those before the operation(P < 0.05).There was no significant difference in UCDVA and BCDVA between the two groups(P > 0.05).The post-operative UCIVA in group A was significantly better than in group B(P < 0.05).The post-operative UCNVA in group B was significantly better than in group A(P < 0.001).The OSI,MTF Cut off,SR,OV100%,OV20%,and OV9% in group A were significantly higher than in group B,and the differences were statistically significant(P < 0.001).The total ocular aberrations,total ocular higher-order aberrations,coma aberration,spherical aberration,trefoil aberration,and second-order astigmatism in group B were significantly higher than in group A(P < 0.05).There was no significant difference in the total low-order aberrations,defocus,and astigmatism between the two groups(P > 0.05).The post-operative VF-14 scores of groups A and B were 89.67±9.71 and 85.50±10.91,respectively,and the difference between the two groups was statistically significant(P < 0.05).There was no significant difference between the two groups in the rate of spectacle independence,post-operative satisfaction,and night visual disturbance symptoms(P > 0.05).Conclusion: The two kinds of IOL can effectively improve the patients’ near,intermediate,and distance visual acuity and visual quality,achieving a high spectacle independence rate and patient satisfaction.In comparing the two IOLs,the extended depth of focus IOL can provide higher intermediate visual acuity and better subjective and objective visual quality.The regional refractive multifocal IOL has an advantage in near vision.