Analytical Research On The Change Characteristics Of Visual Function After Implantation Of Four Intraocular Lenses Of Different Design Principle

Purpose:Four intraocular lenses(IOLs)of different design principle were compared in terms of visual function and its change characteristics in the early and middle stages after implantation,so as to provide comprehensive reference for individual selection ofIOLs in clinic.Method:In this study,91 patients(91 eyes)who accepted cataract surgery were included and divided into four groups according to the type of the implantedIOLs,including:monofocal intraocular lenses(MonIOLs)group(21 eyes),segmental refractive intraocular lenses(Seg RefIOLs)group(19 eyes),diffractive intraocular lenses(DifIOLs)group(29 eyes)and extended-depth-of-focus intraocular lenses(EDo FIOLs)group(22 eyes).Standard visual acuity chart,i Trace visual function analyzer and OQAS-Ⅱvisual quality analysis system were used to check the visual acuity,wavefront aberration and visual quality of the operative eye.The best corrected distance visual acuity(BCDVA),best corrected intermediate visual acuity(BCIVA)and best corrected near visual acuity(BCNVA),total high-order wavefront aberration(THOA),encircled energy function(EEF),objective scattering index(OSI),modulation transfer function cutoff frequency(MTF cutoff),strehl ratio(SR)and predicted visual acuity(PVA)in 100%,20% and 9% contrast states were predicted and compared horizontally and vertically at the 1st week,the 1st month,the 3rd month and the 6th month after surgery.Meanwhile,the correlation between BCDVA and aberration indexes and visual quality indexes has been analyzed at the 6th month after surgery.Results:Horizontal comparison1.At 1 week after surgery,BCIVA of DifIOLs group was lower than that of Seg RefIOLs group and EDo FIOLs group,and the OSI of DifIOLs group was higher than that of EDo FIOLs group(P < 0.05),and the other indexes were not statistically different between the groups(P > 0.05).2.At 1 month after surgery,THOA of Seg RefIOLs group was higher than that of other groups,MTF cutoff and PVA100% of Seg RefIOLs group were lower than that of MonIOLs group and EDo FIOLs group,OSI of Seg RefIOLs group was higher than that of MonIOLs group,SR and PVA20% and PVA9% of Seg RefIOLs group were lower than that of EDo FIOLs group;The BCIVA of DifIOLs group was lower than that of EDo FIOLs group,and the OSI of DifIOLs group was higher than that of MonIOLs group(P < 0.05),and the other indexes were not statistically different between the groups(P > 0.05).3.At 3 months after surgery,OSI of MonIOLs group was lower than that of other groups.THOA of Seg RefIOLs group was higher than that of other groups,SR and PVA20% of Seg RefIOLs group were lower than that of EDo FIOLs group and MonIOLs group,PVA9% of Seg RefIOLs group was lower than that of MonIOLs group.BCIVA of DifIOLs group was lower than that of Seg RefIOLs group and EDo FIOLs group,MTF cutoff and PVA100% and PVA9% of DifIOLs group were lower than that of MonIOLs group,and EEF of DifIOLs group was higher than that of MonIOLs group(P < 0.05),and the other indexes were not statistically different between the groups(P > 0.05).4.At 6 months after surgery,OSI and EEF of MonIOLs group were lower than that of Seg RefIOLs group and DifIOLs group,MTF cutoff and PVA100% of MonIOLs group were higher than that of DifIOLs group and Seg RefIOLs group,SR and PVA20% and PVA9% of MonIOLs group were higher than that of Seg RefIOLs group.THOA of Seg RefIOLs group was higher than that of other groups.BCIVA of DifIOLs group was lower than that of Seg RefIOLs group and EDo FIOLs group.BCNVA and OSI of EDo FIOLs group were lower than that of Seg RefIOLs group and DifIOLs group,MTF cutoff and PVA100% and PVA20% of EDo FIOLs group were higher than that of Seg RefIOLs group(P < 0.05),and the other indexes were not statistically different between the groups(P > 0.05).Vertical comparison1.In the MonIOLs group,THOA,EEF and OSI were significantly decreased from 1 week to 1 month after surgery(P < 0.05),and BCDVA,PVA 100% and PVA9% were significantly increased from 1 week to 1 month after surgery(P < 0.05).Moreover,BCDVA,OSI,MTF cutoff,SR,PVA 100%,PVA 20% and PVA 9%showed no significant change trend after 3 months after surgery.2.The EEF of Seg RefIOLs group had the most obvious decrease from 1 week to1 month after surgery(P < 0.05),and the BCIVA and SR had the most obvious increase from 1 week to 1 month after surgery(P < 0.05).EEF showed no significant change after 1 month after surgery.BCIVA and BCNVA showed no significant change after 3 months after surgery.3.In DifIOLs group,THOA,EEF and OSI were most significantly decreased from 1 week to 1 month after surgery(P < 0.05),and BCIVA,BCNVA were most significantly improved from 1 week to 1 month after surgery(P < 0.05).BCIVA and THOA showed no significant trend after 1 month after operation.OSI,MTF cutoff and PVA 100% showed no significant trend after 3 months after operation.4.In EDo FIOLs group,THOA and EEF were the most significantly decreased from 1 week to 1 month after surgery(P < 0.05),while BCDVA,BCIVA,MTF cutoff,SR,PVA 100%,PVA 20% and PVA 9% were the most significantly increased from 1week to 1 month after surgery(P < 0.05).The BCNVA showed no significant trend after 1 week after operation;MTF cutoff,SR,PVA 100%,PVA 20%,PVA 9% showed no significant trend after 1 month after operation;BCDVA showed no significant trend after 3 months after operation.Correlation analysisAt the 6th month after surgery,MTF cutoff,SR,PVA100%,PVA20% and PVA9% of DifIOLs group were positively correlated with BCDVA(P < 0.05),while OSI of DifIOLs group and EDo FIOLs group was negatively correlated with BCDVA(P < 0.05).Conclusion:1.The postoperative visual acuity of DifIOLs and the postoperative near visual acuity of EDo FIOLs were slightly worse than those of otherIOLs.The objective visual function of MonIOLs and EDo FIOLs was better than that of DifIOLs and Seg RefIOLs.2.The postoperative visual acuity and objective visual function of MonIOLs,Seg RefIOLs,DifIOLs and EDo FIOLs all showed an improvement after implantation.The stabilization of postoperative visual acuity of MonIOLs,Seg RefIOLs and EDo FIOLs was earlier than that of DifIOLs,and the stabilization of postoperative optical quality of them was late.The postoperative visual quality of EDo FIOLs was stabilized earlier than that of MonIOLs,and the postoperative visual quality of MonIOLs was stabilized earlier than that of Seg RefIOLs and DifIOLs.3.The postoperative visual acuity and objective visual function of MonIOLs and EDo FIOLs and the postoperative visual acuity of DifIOLs showed the most significant improvement in the early postoperative period.4.All postoperative visual quality indicators of DifIOLs measured by OQAS are highly correlated and consistent with postoperative distant visual acuity.