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AIM: To investigate the effect of residual astigmatism on visual quality after phacoemulsification combined with regional refractive intraocular lens(IOL)implantation in patients with age-related cataract, and to evaluate the astigmatism inclusivity of regional refractive IOL.METHODS: Retrospective cohort study. The clinical data of 62 cases(73 eyes)of age-related cataract patients who underwent phacoemulsification combined with regional refractive IOL(Lentis Comfort LS-313 MF15)implantation from July 2020 to March 2022 at the ophthalmology department of our hospital were collected. They were grouped according to residual astigmatism at 6 mo postoperatively, taking 35 cases(40 eyes)with residual astigmatism of 0.75 D to 1.50 D as the experimental group, and 27 cases(33 eyes)with residual astigmatism ≤0.75 D as the control group. Visual acuity, defocus curves, objective visual acuity [wavefront aberrations, Strehl ratio(SR), modulation transfer functions(MTF)], subjective visual acuity(national eye institute visual function questionnaire-25), patients' satisfaction, and spectacle independence were compared between the two groups at 6 mo postoperatively.RESULTS:There was a difference in the preoperative astigmatism and the number of postoperative 6 mo residual astigmatism between the two groups(P<0.01). At 6 mo postoperatively, there was no difference in uncorrected distance, intermediate, and near visual acuity, objective visual quality, subjective visual quality, satisfaction, and spectacle independence between the two groups(P>0.05). The defocus curves showed that there was no difference in visual acuity between the two groups at all points in the +2.00 to -4.00 D defocus range of the additional spherical equivalent(P>0.05).CONCLUSION:Lentis Comfort LS-313 MF15 IOL was able to accommodate regular astigmatism of 1.50 D.
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@#AIM: To investigate the effects of long-term orthokeratology lens wearing on corneal morphology, corneal biomechanics and objective visual quality.METHODS: A retrospective study was conducted to collect 33 myopic patients(60 eyes), including 19 males(35 eyes)and 14 females(25 eyes), mean age 11.80±1.51 years old, with an average equivalent spherical lens of -3.25±0.69D, who had been wearing orthokeratology lens for 2a from October 2019 to December 2020 in our hospital. Relevant data were collected before wearing and 2a after wearing. The radius of curvature(ARC and PRC), the thickness of the thinnest cornea(THP)and the index of comprehensive deviation analysis of corneal dilation(BADD)were measured by Pentacam anterior segment analysis system. Corvis ST biomechanical analyzer measured non-contact biomechanical corrected intraocular pressure(blOP), maximum deformation amplitude(DA), maximum reverse radius(HCR), ratio of deformation amplitude between apex and 1mm(DR), hardness parameters(SPA1), and corneal biomechanical parameters(CBI). The biomechanical index(TBI)of CT scan was obtained by the combined diagnosis system of Pentacam and Corvis ST. OQAS-II objective visual quality analysis system measured modulation transfer function cutoff frequency(MTF cutoff), Stryl ratio(SR), objective scattering coefficient(OSI)and OV value(OV100%, OV20% and OV9%). The above parameters were compared before and continuously wearing orthokeratoscope for 2a. RESULTS: After 2a of wearing orthokeratology, ARC increased, THP decreased, and BADD increased(<i>t</i>=-9.38, 2.85, -13.08; all <i>P</i><0.05), while there was no significant difference between PRC and before wearing(<i>t</i>=1.49, <i>P</i>>0.05). DA increased and HCR decreased compared with before wearing orthokeratology lens(<i>t</i>=-2.37, 2.28; all <i>P</i><0.05), but bIOP, DR, SPA1, CBI and TBI showed no difference(<i>t</i>=1.36, -1.87, 1.27, -0.95, -1.49; all <i>P</i>>0.05). SR was higher than before, OV20% and OV9% were lower than before(<i>t</i>=-5.31, 8.37, 2.34; all <i>P</i><0.05), MTF cutoff, OSI and OV100% had no difference compared with before(<i>t</i>=-1.57, -1.35, 1.11; all <i>P</i>>0.05).CONCLUSION: Long-term wearing of orthokeratology lens changed the morphology of the anterior corneal surface, but had no significant effect on the corneal biomechanics, and the objective visual quality of patients was improved during the day, but decreased at night.
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@#AIM:To review the objective visual quality after multifocal intraocular lens implantation.<p>METHODS:The PubMed, The Cochrane Library, CNKI, Sinomed, Metstr, Wanfang Database were searched for Meta-analysis of the literature on the objective visual quality after multifocal intraocular lens implantation. The retrieval time limit is from the establishment of the database to December 31, 2019. The objective visual quality was evaluated based on the objective visual quality analysis system Ⅱ(OQAS Ⅱ), which included object scatter index(OSI), modulation transfer function cut off(MTF cut off), Strehl ratio(SR), predicted 100% contrast visual acuity(OV100%), predicted 20% contrast visual acuity(OV20%), and predicted 9% contrast visual acuity(OV9%).<p>RESULTS: A total of 8 articles met the inclusion criteria of this study, a total of 432 cases(567 eyes). Meta-analysis showed that there was significant difference between multifocal intraocular lens and monofocal control group in OSI \〖<i>MD</i>=0.66, 95% <i>CI</i>(0.42-0.90), <i>P</i><0.05\〗, but there was no significant difference in MTF cut off \〖<i>MD</i>=-1.94, 95% <i>CI </i>(-5.58-1.70), <i>P</i>=0.30\〗, SR\〖<i>MD</i>=0.00, 95%<i>CI </i>(-0.02-0.02), <i>P</i>=0.87\〗, OV100% \〖<i>MD</i>=-0.02, 95%<i>CI</i>(-0.14-0.11), <i>P</i>=0.76\〗, OV20% \〖<i>MD</i>=-0.03, 95% <i>CI</i>(-0.14-0.08), <i>P</i>=0.60\〗, OV9% \〖<i>MD</i>= -0.01, 95% <i>CI </i>(-0.09-0.07), <i>P</i>=0.82\〗.<p>CONCLUSION: The increase of objective scattering after multifocal intraocular lens implantation may lead to the decrease of visual quality, and the other parameters have no significant difference with the control group. However, no patient follow-up was reported in the included studies. Due to the changes and adaptability after operation, the long-term evaluation of objective visual quality of patients after multifocal intraocular lens implantation needs further research.