Comparison of Binocular Visual Quality in Six Treatment Protocols for Bilateral Cataract Surgery with Presbyopia Correction: a Prospective Two-center Single-blinded Cohort Study

Overview

Journal Ann Med

Publisher Informa Healthcare

Specialty General Medicine

Date 2023 Sep 21

PMID 37734409

Authors

Qianqian Lan

Fan Xu

Tong Sun

Siming Zeng

Yiyun Liu

Tingting Yang

Yaxin Li

Gang Yao

Baikai Ma

Liyuan Tao

Boping Ma

Xin Xiao

Min Li

Hong Qi

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the postoperative binocular visual quality in six treatment protocols for bilateral age-related cataract surgery with presbyopia correction for clinical decisions.

Materials And Methods: In this prospective two-center single-blinded cohort study, participants from North or South China who underwent bilateral phacoemulsification and intraocular lens implantation were divided into six protocols: monovision, diffractive bifocal, mixed, refractive bifocal, trifocal, and micro-monovision extended range of vision (EROV). Binocular visual quality was evaluated at 3 months postoperatively, including binocular uncorrected full-range visual acuity, binocular defocus curves (depth of focus [DoF] and area under the curve [AUC]), binocular visual function (fusion function and stereopsis), binocular subjective spectacle independence rates, visual analog scale (VAS) of overall satisfaction, 25-item visual function questionnaire (VFQ-25), and binocular dysphotopsia symptoms.

Results: Of the 300 enrolled patients, 272 (90.7%; 544 eyes) were analyzed. The trifocal protocol showed excellent binocular full-range visual acuity and the best performance for most DoFs and AUCs. The monovision protocol presented the worst binocular visual quality in most perspectives, especially in convergence, distance, and near stereopsis ( < 0.001). The full-range subjective spectacle independence rates were sorted from highest to lowest as follows: trifocal (84.8%), refractive bifocal (80.9%), EROV (80.0%), mixed (73.3%), diffractive bifocal (65.2%), and monovision (32.6%) protocols, with no statistically significant differences between the former five protocols ( > 0.05). The EROV protocol achieved the highest VAS and VFQ-25 scores. The incidence of postoperative binocular dysphotopsia symptoms was comparable in all protocols.

Conclusions: The trifocal protocol showed the best performance, and the monovision protocol presented the worst performance in most perspectives of binocular visual quality for presbyopia correction. The refractive bifocal, mixed, or EROV protocols can provide an approximate performance as a trifocal protocol. Ophthalmologists can customize therapies using different protocols.

Citing Articles

Bilateral Femtosecond Laser-Assisted Clear Lens Extraction with Trifocal Intraocular Lens Implantation for Presbyopia Correction: A Short-Term Observational Study in Chinese Adults.

Li Q, Xie X, Yang J, Gao P, Li W Clin Ophthalmol. 2024; 18:623-630.

PMID: 38481540 PMC: 10936733. DOI: 10.2147/OPTH.S453143.

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