Objective: To investigate the objective and subjective visual quality after a segmental refractive multifocal intraocular lens (IOL) implantation. Methods: This prospective study enrolled cataract patients who underwent phacoemulsification and IOL implantation at our hospital between December 2015 and March
2016. The patients were divided into two groups (each with 14 patients, 22 eyes) based on the IOL type: segmental refractive multifocal IOL (MF30, Oculentis, Holland) as the trial group, and single focal IOL(SN60WF, Alcon, USA) as the control group. Three months after surgery, the spherical equivalent (SE) was measured, and the best-corrected distance visual acuity (BCDVA=5-LogMAR), best-corrected intermediate visual acuity (BCIVA=5-LogMAR), best-corrected near visual acuity (BCNVA=5-LogMAR), and defocus curve were recorded. A double-pass optical quality analysis system (OQAS II, VISIOMETRICS, Spain) was used to
measure the modulation transfer function (MTF), objective scatter index (OSI), Strehl Ratio (SR), and contrast visual acuity. The near spectacle independence, satisfaction, and symptoms of visual disturbance were assessed by a questionnaire. Data were analyzed using independent t test and chi-square test. Results: Three months after surgery, the SE in the trial and control groups were 0.23±0.30 diopter (D) and 0.09±0.51D, respectively (t=1.051, P=0.300); BCDVA was 5.00±0.05 and 4.99±0.03, respectively (t=0.516, P=0.608); BCIVA was 4.83±0.07 and 4.65±0.11, respectively (t=6.610, P<0.001); BCNVA was 4.88±0.04 and 4.51±0.12, respectively (t=14.485, P<0.001); MTF cutoff was 25.23±12.26 and 32.56±8.06 cpd, respectively (t=2.249, P=0.030); OSI was 2.38±0.67 and 1.64±0.84, respectively (t= 3.234, P=0.020). There were no statistical differences between the groups for SR or contrast visual acuity. The defocus curve was smooth within −3.0 D and +1.0 D in the trial group, while only one peak appeared between −0.5 D and +0.5 D in the control group. Near spectacle independence was 91% in the trial group and 12% in the control group (χ2=21.316, P<0.001). Satisfaction was 80% (16/20) and 59% (10/17), respectively (χ2=1.089, P=0.279); Halo/glare was 9% (2/22) and 0% (0/17),respectively (χ2=0.296, P=0.495). Conclusions: The visual quality of the segmental refractive multifocal IOL was clinically acceptable as it offers a full range of visual acuity with few symptoms of visual disturbance.
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