Short-term objective visual quality comparison between after implantation of segmental refractive multifocal intraocular lens and aspheric-surface monofocal intraocular lens

Abstract

Objective To compare the short-term postoperative quality of vision of segmental refractive multifocal intraocular lens (MIOL) SBL-3 and aspheric-surface monofocal intraocular lens Akreos Adapt AO. Methods 26 cases of age-related cataract (35 eyes) after phacoemulsification cataract extraction combined with IOL implantation were collected from June of 2017 to January of 2018 in the Peking University First Hospital. There were 15 eyes in SBL-3 group, and 20 eyes in AO group according to the different types of IOL implanted. At 1 month after operation the following parameters of the two groups were assessed: uncorrected distant visual acuity(UDVA), uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), corrected distant visual acuity(CDVA), corrected near visual acuity (CNVA), distance-corrected intermediate visual acuity(DCIVA), distance-corrected near visual acuity(DCNVA). And analyze total higher order aberrations (ocular, corneal, internal), spherical aberration, point spread function for 4mm and 6mm optical zone. Defocusing curve of SBL-3 group was also drawn at 1 month postoperatively. The two groups of patients, UDVA, CDVA, CNVA, UIVA, UNVA, DCIVA, DCNVA and visual quality were expressed as mean standard deviation (±s), and were compared with non parametric Mann-Whimey U test. Results At 1 month after operation, the UIVA, UNVA, DCIVA and DCNVA in SBL-3 group [(0.32±0.08), (0.44±0.18), (0.30±0.10), (0.33±0.11)] were all better than that of the eyes in AO group [(0.25±0.10), (0.27±0.09), (0.20±0.07), (0.21±0.10)] (Z=-2.26, -3.13, -1.84, -2.17; P>0.05). But there were no statistical differences between two groups in UDVA, CDVA and CNVA(Z=-0.99, 0, -1.84; P>0.05). The visual quality assessment showed that the difference of eyeball difference between the two groups with the pupil diameter of 4 mm was not statistically significant (Z=-1.50, -1.04, -0.82; P>0.05), and the difference of eyeball difference between the two groups with 6 mm pupil diameter was not statistically significant (Z=-0.12, -1.93, -1.16; P>0.05). The total higher order aberrations of ocular for 4mm and 6mm optical zone in SBL-3 group [(0.45±0.12), (1.41±0.21)] were better than that in AO group [(0.26±0.12), (0.82±0.13)] (Z=-3.45, -3.24; P<0.05). But there were no statistical differences between two groups in spherical aberration. The point spread function in SBL-3 group (0.05±0.02) was lower than that in AO group (0.11±0.07) (Z=-2.60, P<0.05). There is a peak appeared at 0 D and the defocusing curve was smooth within -1.0 D and -3.0 D but was steep within -3.0 D and -5.0 D. Conclusions The objective visual quality of Adapt AO is better than that of SBL-3 lens, but the application of SBL-3 lens in medium and near vision is better than that of Adapt AO lens. The peak of the defocus curve of SBL-3 lens appeared at 0 D, and the curve in -1.0 D to -3.0 D was stable, and the decrease was not obvious. This study also needs to expand the sample size and observe its efficacy and safety in the long term. Key words: Segmental refractive; Multifocal; Intraocular lens; Quality of vision; Defocusing curve