| PurposeThe purpose of this study was to evaluate the medium-and long-term stability of visual quality after regional refraction multifocal intraocular lens(MIOL)implantation by observing the visual acuity and visual quality 24 months after regional refraction MIOL implantation,compared with diffracted MIOL and monofocal intraocular lens(IOL).MethodsA retrospective case-control study was conducted on 171 patients(221 eyes)who underwent cataract phacoemulsification combined with intraocular lens implantation in the Ophthalmology Center of the first affiliated Hospital of Zhengzhou University from October 2016 to October 2017.According to the type of IOL implanted during operation,they were divided into three groups.In group A,72 cases(87 eyes)were implanted with regional refraction MIOL(Lentis Mplus LS-313 MF30,Oculentis,Holland).In group B,45 cases(58 eyes)were implanted with diffractive multifocal intraocular lens(Tecnis ZMB00,Johnson&Johnson Vision,USA).In group C,54 cases(76 eyes)were implanted with monofocal intraocular lens(Akreos MI60,American Bausch&Lomb Corporation).The clinical data of uncorrected distant visual acuity,uncorrected intermediate visual acuity,uncorrected near visual acuity,corrected distant visual acuity,defocus curve,contrast sensitivity,total high-order aberration,spherical aberration,coma aberration,trefoil aberration,secondary astigmatism,Strehl ratio,modulation transfer function((MTF)),questionnaire and complications were collected 24 months after operation.The quantitative data did not accord with normal distribution after Shapiro-Wilk test,so nonparametric Kruskal-Wallis rank sum test was used.Chi-square test was used for qualitative data.The level of significance was P<0.05.If the difference is statistically significant,then make a comparison between the two groups,and the significant level of the comparison between the two groups is P<0.0167.Results24 months after operation,there was no significant difference in uncorrected distant visual acuity and corrected distant visual acuity among the three groups(P=0.707,0.662).The uncorrected intermediate visual acuity of group A was better than that of group B and group C,and the difference were statistically significant(P=0.000,0.000).The uncorrected near visual acuity in group A was better than that in group C,and the difference was statistically significant(P=0.000).There was no significant difference in uncorrected near visual acuity between group A and group B(P=0.184).There were no significant difference in all spatial frequency contrast sensitivity between group A and group C in bright glare(P=0.041,0.469,0.139,0.114),bright without glare(P=0.074,0.471,0.215,0.110),dim glare(P=0.259,0.958,0.074,0.305)and dim without glare(P=0.136,0.344,0.067,0.240)environment.The contrast sensitivity of 3c/d and 6c/d in group A was better than that in group B under the condition of bright without glare(P=0.000,0.000),bright with glare(P=0.000,0.000),dim without glare(P=0.000,0.000)and dim with glare(P=0.001,0.000),and the difference were statistically significant.Under the 5mm pupil diameter,the spherical aberration in group A was larger than that in group B,and the difference was statistically significant(P=0.001).There was no significant difference in spherical aberration between group A and group C(P=0.759).Under the 5mm pupil diameter,the total high-order aberrations(P=0.000,0.000),coma aberration(P=0.000,0.000),trefoil aberration(P=0.002,0.000)and secondary astigmatism(P=0.002,0.000)in group A were higher than those in group B and group C,and the difference were statistically significant.The Strehl ratio in group A was lower than that in group B and group C,and the difference were statistically significant(P=0.000,0.000).Under the pupil diameter of 5mm,there was no significant difference in MTF between group A and group C at 5c/d,10c/d,15c/d,20c/d,25c/d and 30c/d(P=0.467,0.719,0.889,0.652,0.189,0.692).Under the 5mm pupil diameter,the MTF value of 5 c/d spatial frequency in group A was higher than that in group B,and the difference was statistically significant(P=0.000).The incidence of visual interference in group A,B and C was 12.50%,15.56%and 5.56%respectively,and the difference were not statistically significant(P=0.256).The rate of complete independent on glasses in group A was 97.2%higher than that in group B 82.2%and group C 50.0%.The difference was statistically significant(P=0.013,0.000).The total score of quality of life survey in group A was higher than that in group B and group C,and the difference was statistically significant(P=0.000,0.000).The score of intermediate visual satisfaction in group A was higher than that in group B and group C,and the difference were statistically significant(P=0.000,0.000).The scores of near visual acuity and overall visual acuity in group A were higher than those in group C,and the difference were statistically significant(P=0.000,0.000).There were significant difference in the scores of near visual acuity and overall visual acuity between group A and group B(P=0.488,0.551).There were no significant difference in daytime visual acuity,night visual acuity and long-distance visual acuity among groups A,B and C(P=0.258,0.366,0.966).The incidence of posterior capsular opacification was 8.05%(7/87)in group A,5.17%(3/58)in B group,13.16%(10/76)in C group.There was no significant difference between the two groups(P=0.383).ConclusionsRegional refraction MIOL can provide good and stable near and distant vision,and can provide better intermediate visual acuity than diffracted MIOL and monofocal IOL,and the proportion of glasses independent is higher.The contrast sensitivity of patients after regional refractive MIOL implantation is similar to that of monofocal IOL,and the contrast sensitivity of regional refractive MIOL is better than that of diffracted MIOL at low spatial frequency.After regional refraction MIOL implantation,the total high-order aberration,coma aberration,trefoil aberration and secondary astigmatism were higher than those of diffracted MIOL and monofocal IOL,and the Strehl ratio was lower than diffracted MIOL and monofocal IOL,but the incidence of visual interference was lower,the quality of life was high,the satisfaction score was high,and had good medium and long term visual acuity and visual quality stability. |
PDF Full Text Request