Surgical Effect after Refractive Rotationally Asymmetric Multifocal Intraocular Lens Implantation

Abstract

Objective: To observe the early effect of phacoemulsification cataract surgery with the implantation of a refractive rotationally asymmetric multifocal intraocular lens (IOL). Methods: This was a self-controlled, before-after trial in which 36 patients (40 eyes) underwent phacoemulsification cataract surgery combined with the refractive rotationally asymmetric multifocal IOL implantation in Wuhan Aier Eye Hospital from January to December 2017. Uncorrected distance visual acuity (UDVA, LogMAR), uncorrected intermediate visual acuity (UIVA, LogMAR), uncorrected near visual acuity (UNVA, LogMAR) and corrected distance visual acuity (CDVA, LogMAR), postoperative spherical equivalent (SE), defocus curve and modulation transfer function (MTF), intraocular high-order aberrations, visual function index of life quality and the rate of spectacle independence were evaluated 3 months postoperatively. Paired t-tests and non-parameter Wilcoxon pairing rank were used to analyze the data. Results: At 3 months postoperatively, there was a significant improvement in UDVA, CDVA, UIVA and UNVA (P<0.05), 72% of postoperative UDVA was better than 0.1, 98% of postoperative CDVA was better than 0.1; 35 eyes (88%) were within ±1.00 diopter (D) of emmetropia. The defocus curve showed two peaks of maximum visual acuity (0 and -2.5 D of defocus) and the visual acuity of +1.0 D- -4.0 D defocus was better than 0.25. With 3 mm pupil diameters, the MTF improved significantly compared to preoperative levels (P<0.05); improvement in total intraocular aberrations, vertical coma and vertical trefoil was observed (P<0.05). The median score of the Chinese version of the visual function index-12 (VF-12-CN) was 1.0 (0.0, 2.0) at 3 months. 92% of the patients were completely independent of spectacles for far and near vision. Conclusions: The refractive rotationally asymmetric multifocal intraocular IOL provides satisfying visual acuity for far and near with a good range of intermediate vision. Patients have good visual quality and high quality of life. Key words: refractive rotationally asymmetric; multifocal intraocular lens (IOL); visual quality; high-order aberrations