Correlation and predictability of ocular aberrations and the visual outcome after quadrifocal intraocular lens implantation: a retrospective longitudinal study

Chia-Yi Lee,Hung-Yu Lin,Chi-Chin Sun,Shun-Fa Yang,Jing-Yang Huang,Hung-Chi Chen

doi:10.1186/s12886-019-1195-x

Abstract

BackgroundTo evaluate the correlating and predicting factors of visual outcome after implantation of newly developed diffractive quadrifocal intraocular lens (IOL).MethodsA retrospective longitudinal study was conducted. Patients who underwent diffractive quadrifocal IOL implantation with a follow-up period longer than six months and records of wavefront aberrometer within one week perioperatively were enrolled. Accordingly, a total of 73 eyes from 73 patients were included. The postoperative distance and near visual acuity, ocular aberrations and postoperative symptoms were collected. The correlation and predictability between ocular aberrations and the postoperative visual outcome were evaluated.ResultsThe corrected distance visual acuity (CDVA) one month postoperatively was significantly better than the preoperative status, and insignificant improvement was found six months postoperatively. Preoperative Tracey refraction spherical equivalent (TRSE), angle alpha, and spherical aberration (SA) were significantly correlated with postoperative CDVA and near corrected visual acuity (NCVA). For postoperative ocular aberrations, TRSE, angle alpha, and SA were significantly correlated with CDVA six months postoperatively and NCVA, while the trefoil, internal higher order aberration (HOA) and total HOA were associated with NCVA. Preoperative angle alpha could predict all postoperative visual performances, while postoperative TRSE and angle alpha could predict the CDVA six months postoperatively and NCVA. A large angle alpha is associated with visual disturbance and dissatisfaction.ConclusionThe angle alpha preoperatively and postoperatively was correlated with the postoperative vision and could predict visual outcome in patients who had diffractive quadrifocal IOL implanted. Furthermore, the majority of ocular aberrations were also associated with certain postoperative vision.

Highlights

Cataracts are the leading cause of reversible blindness and account for approximately 57% of visual impairment in the Chinese population [1]
The current study demonstrated that the preoperative as well as postoperative Tracey refraction spherical equivalent (TRSE) and angle alpha yielded significant estimation value for both far and near vision postoperatively with significant differences
In conclusion, the preoperative and postoperative TRSE, angle alpha and spherical aberration (SA) were negatively correlated with the postoperative visual acuity, while a smaller angle alpha could positively predict better far and near visual outcomes in patient who received diffractive quadrifocal intraocular lens (IOL) implantation

Summary

Introduction

Cataracts are the leading cause of reversible blindness and account for approximately 57% of visual impairment in the Chinese population [1]. Surgery is always advocated to treat patients with prominent cataracts for preserving vision [2]. Phacoemulsification accompanied with monofocal intraocular lens (IOL) implantation has. The multifocal IOL has been widely applied to patients scheduled for cataract surgery [5,6,7]. The near and intermediate visions are significantly better compared to those of traditional monofocal IOLs, according to previous experiences that patients who have multifocal IOL implanted do not need to wear spectacles [7,8,9,10]. Some patients who have multifocal IOL implanted have suffered from halo and glare, . To evaluate the correlating and predicting factors of visual outcome after implantation of newly developed diffractive quadrifocal intraocular lens (IOL)

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