Effect On Postoperative Visual Quality Of Different Modern Cataract Surgery Methods And Intraocular Lens Choices

The objective of this study is to explore the influence of combined femtosecond laser and phacoemulsification on postoperative curative effect and safety on cataract patients,to evaluate postoperative visual quality of femtosecond assisted phacoemulsification,and to compare the visual quality of different aspheric intraocular lens(IOLs)implantation.One hundred forty-five cataract patients(148 eyes)needing operation were selected and grouped by different operation method:control group,72 patients(74 eyes)were treated with traditional phacoemulsification;observation group,73 patients(74 eyes)were treated with femtosecond laser assisted by phacoemulsification.Through detailed ophthalmic examinations of all patients,intra-operative Cumulative Dissipated Energy(CDE)value,pre-operative corneal endothelial cell counting and LogMAR vision examination,as well as intra-operative CDE value and pre-operative corneal endothelial cell counting were used to evaluate safety of combined femtosecond laser and phacoemulsification in treating cataract.Vision difference was used to evaluate the influence of operative treatment on visual functions.The result showed that the mean CDE value of grade II nucleus in the observation group was 6.41 ± 3.12,and the mean CDE value of grade III nucleus was]7.48 ± 4,72,which had significant differences from those of the control group(P<0.001).In the observation group,accumulative energy release of grade II nucleus reduced by 28.43%and that of grade III nucleus reduced by 22.61%.Corneal endothelial cell counts of patients in the control group 3 months after the operation were within 2,091.3 ± 492.81(/mm2),which were significantly lower than those(2,317.8±512.77(/mm2))of the observation group(P<0.05).In the aspect of operation effect,vision examination results at different time points before and after the operation did not have statistical significance(P>0.05),and combined femtosecond laser and phacoemulsification had the same curative effect on the restoration of visual functions of senile cataract as traditional phacoemulsification did.Also the MTF and entire spherical aberration did not have statistical significance.When curative effects were consistent,combined femtosecond laser and phacoemulsification could reduce intra-operative accumulative energy release,avoid intra-operative additional damage of corneal endothelial cells,and significantly im-improve safety in comparison with traditional phacoemulsification technique.However,it did not demonstrate significant better visual quality compared with traditional phacoemulsification.We evaluated 50 patients(61 eyes)with implantation of different aspheric IOLs(SN60WF IOLs,ZCB00 IOLs,PY-60AD IOLs,AO IOLs)more than 6 months after cataract surgery.24 patients(30 eyes)had iTrace guided implantation of aspheric IOLs and 26 patients(31 eyes)having randomized implantation of aspheric IOLs was designed as a control group.Parameters analyzed more than 3 months postoperatively included monocular best-corrected visual acuity(BCVA),total spherical aberration Z(4,0)at 3mm and 5mm pupil size,MTF,and patients satisfaction.The quality of life after operation was assessed through the National Eye Institute Visual Function Questionnaire-25(NEI VFQ-25).3 months after cataract operation,the mean postoperative entire spherical aberration Z(4,0)at 5mm pupil size in i-trace guided group was 0.015±0.028um,and in the control group was 0.043±0.109um,with a statistically significant difference(P<0.01).Patients from both 2 groups got better visual acuity after surgery than before,and were satisfied with the result,the mean scores obtained from NEI VFQ-25 were not different significantly.In the meanwhile,MTF of i-trace guided group showed significantly higher than the control group at 5mm pupil size,but no significant difference at 3mm pupil size.That is to say,it is effective to implant aspheric IOLs individually according to the spherical aberration of cornea before cataract surgery,leading to total spherical aberration Z(4,0)decreasement.Patients got better MTF after implanting aspheric IOLs guided by iTrace at 5mm pupil size.But there is no significant difference in BCVA,and subjective visual function.