Observation Of Visual Quality After Monocular Refractive Cataract Surgery

To evaluate visual quality in patients undergoing monocular or bilateral cataract surgery with trifocal intraocular lens (IOL) implantation.

Lixiang Eye Hospital of Soochow University

We conducted a single-center, prospective, observational research. This study included 62 eyes of 31 patients who received trifocal IOL implantation in one eye only (observation group), and 62 eyes of 31 patients who received bilateral trifocal IOL implantation (control group).Three months postoperatively, monocular and binocular distance, intermediate, and near visual acuity, modulation transfer function (MTF), Strehl ratio (SR), total ocular higher order aberrations, and three-level visual function were assessed. A questionnaire was used to evaluate spectacle independence, light disturbance, overall satisfaction, and quality of life.

Both groups improved in monocular UDVA postoperatively (P<0.05). No intergroup differences existed in UDVA, binocular acuity, MTF, SR, aberrations, VF-14-CN, or satisfaction (P>0.05). Three-level visual function was better in controls (P<0.05). Simultaneous vision correlated with higher-order aberration differences; fusion vision correlated with UIVA difference (r=0.410, P=0.027). Stereopsis correlated with binocular UIVA (r=0.545, P=0.002) and UNVA differences (r=0.474, P=0.009). Regression showed bilateral UIVA difference >0.439 indicated abnormal fusion; >0.472 indicated absent stereopsis.

Patients with either monocular or bilateral trifocal IOL implantation achieved good postoperative visual quality. However, those in the control group exhibited superior three-level visual function. A bilateral UIVA difference

greater than 0.439 impaired binocular fusion, and a difference greater than 0.472 eliminated stereopsis.