Analysis Of Factors Related To Spectacle Dependence In Refractive Cataract Surgery

Background and ObjectivesAdvances in both intraocular lens (IOL) and phacoemulsification technology have enabled Cataract surgery and IOL implantation to become more of a refractive procedure. With implantation of multifocal intraocular lens in refractive cataract surgery, it can provide patients a satisfactory full range of vision and reduce dependence on glasses. However, some patients remain wear spectacles postoperatively, which not only brought suffering to patients, but also intensified the risk of clinical work. This research aims to study the factors that affect the rate of spectacle dependence and to provide guidance for clinical work.MethodsIt was a retrospective study.182 cases (222 eyes) with different types of cataracts underwent AcrySof ReSTOR IOL implantation after phacoemulsification during the period from June 2006 to April 2009. In this study, it include 155 cases (190 eyes) with age-related cataract,5 cases (10 eyes) with congenital cataract,15 cases (15 eyes) with complicated cataract and 7 cases (7 eyes) with diabetic cataract. The number and rate of spectacle dependence, refractive status, uncorrected distance and near visual acuity, variations in ocular biometry and ocular complications were recorded. Statistical analysis:Adoption of Chi-square test and t-test, all the materials were analyzed by software SPSS 13.0. Results1.36 cases (39 eyes) still wore spectacles after surgery.23.2%(33/142) of the patients who have been monocularly implanted with ReSTOR MIOL wore spectacles. 7.5%(3/40) of the patients who have been binocularly implanted with ReSTOR MIOL wore spectacles. There was a statistically significant difference between the two groups (χ2=4.872, P=0.027)2. The mean uncorrected distance and near visual acuity were 0.46 and 0.41 respectively. The mean spherical equivalent refraction of patients who wore spectacles was +0.38±1.25D. A significant negative correlation was observed between uncorrected visual acuity and spherical equivalent refraction (r=-0.615,-0.427; P< 0.05)3. The difference between pre- and post-operative axial length measurement was significant (t=3.262, P<0.05).However, no significant difference was found between pre- and post-operative corneal curvature measurement (t=0.248, P>0.05)4.4 eyes with pupil abnormalities and 3 eyes with intraocular lens decentration were observed.6 eyes developed the complication of posterior capsule opacification.Conclusion1. Binocular implantation of multifocal intraocular lens could reduce dependence on spectacles.2. Axial length measurement error might lead to wearing spectacles after cataract surgery.3. Measurement of corneal curvature did not cause significant effect on the rate of wearing spectacles.4. Surgical complications might lead to wearing spectacles after cataract surgery.