| Objective Acrysof +3D IQ Restor Toric intraocular lens(ART IOL) is a new refractive IOL, which could correct corneal astigmatism, presbyopia by aspheric multifocal designs that using cylindrical and spherical lens, ART IOL has been shown to provide full range functional vision not only by using diffractive optical design to provide a good near vision but also by that neutralizing the pre-existing corneal astigmatism and the spherical aberration to extend the clinical indication of multifocal intraocular lens to cataract patients that has pre-existing corneal astigmatism. The current research aim to evaluate the effect of ART IOL on post-operative optical quality including the contrast sensitivity, visual performance, patient satisfaction and values of optical quality analysis system.Methods 1. It was a case-control study. One hundred and fifty eyes of 126 patients that had phacoemulsification surgery done in Tianjin Medical University Eye Hospital from June 2013 to June 2014 were enrolled. They were divided into three groups that contains 50 cases in each group. Experimental Group: The patients had pre-existing corneal regular astigmatism ranged from 0.5-2.5D which had ART IOL implantation. Control Group 1: The patients had pre-existing against-the-rule corneal astigmatism less than 0.75 D. Control Group 2: The patients had pre-existing corneal astigmatism ranged between 1.0D and 3.0D that had Toric IOL implantation.2. The main measurements included OSI, MTF cutoff, Strehl ratio, OVs, contrast sensitivity, uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), distance corrected near visual acuity, intermediate visual acuity(60cm, IVA) at 1day, 1week, 1month, 3months postoperatively. IOL rotation,defocus measurement and Spectacle independence survey were measured at 3monthss after surgery.3.Statistical Analysis: All data were collected in an Excel database(Microsoft Office2003, Microsoft Corp.). Data analysis was performed using SPSS for Windows(version 17.0, SPSS Inc.). Normality of all data samples was checked. The Student t test, ANOVA or LSD analysis were performed. The non-parametric data were compared with the chi-square test. P<0.05 was considered as statistically significant.Results1.UDVA and CDVA(Log MAR): Postoperatively, the mean UDVA were 0.07±0.11,0.10±0.09, 0.08±0.12 respectively among groups. The mean CDVA were 0.02±0.07,0.02±0.07, 0.02±0.07 respectively among groups. The UDCA was 0.3 or better in all eyes. There were no statistically significant differences both UDVA and CDVA among these groups.2.IVA(Log MAR): Postoperatively, the mean uncorrected IVA of experimental group and control group 1 were 0.19±0.12 and 0.21±0.13. No statistically significant differences were noted among groups. The IVA was 0.3 or better in 90% of eyes in experimental group, while the control group 1 was 84%.3.UNVA(Log MAR): Postoperatively, the mean UNVA of experimental group and control group 1 were 0.08±0.11, 0.10±0.11 respectively. No statistically significant differences were noted between groups. The UNVA was J3 or better in 70% of eyes between groups.4.Defocus test: The defocus curve was bimodal shape in experimental group and control group 1. The peak of wave of experimental group and control group 1 were on distant focus and near focus, and the wave trough was on intermediate focus.The defocus curve was unimodal shape in control group 2. The peak of wave of control group 2 was on 0D±.5.The mean absolute misalignment were 4.18±1.60 degrees in experimental group and 3.84±1.68 degrees in control group 2. No statistically significant difference was noted.6. No statistically significant differences were noted among groups in OSI, MTF,OV100, OV20, OV9. There were significant differences in Strehl ratio and contrast sensitivity,but no statistically significant differences were noted between experimental group and control group 1.7. The percentages of spectacle independence were 90%and 88% in experimental group and control group 1 respectively.No significant visual interference problems were noted.Conclusions1. ART IOL implantation is an effective and safe method to correct corneal astigmatism during cataract surgery and had excellent predictability and rotationalstability.2. ART IOL implantation can provide a full range functional vision for patients with an increased rate of spectacle independence and high patient-satisfaction.3. The post-operative contrast sensitivity of patients who had ART IOL implantation has a slightly decrease compared to that of patients who had Toric IOL implantation.The diffractive design of the multifocal IOL could compromise contrast sensitivity in the patients had ART IOL implantation.4. Double-pass optical quality analysis system has a critical role for characterizing the optical quality of the the patients after IOL implantation. |
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