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A model eye is used to study the anatomical structure and optical properties of the eye, and to analyze visual quality under different conditions using optical analysis software. By adjusting biological parameters such as axial length and corneal curvature radius and modifying its refractive state, the model eye can be used for ophthalmic surgical planning and treatment program development, leading to more accurate and objective assessments of visual quality. While previously used mainly for theoretical studies in optics and ophthalmology, model eyes and optical analysis software are now being applied to various ocular diseases, with their accuracy confirmed through comparison with clinical trials. This article aims to summarize the widely used model eyes and optical analysis software, as well as their applications, to offer new perspectives for diagnosing and treating ocular diseases and evaluating visual quality.

AIM: To compare the effect of small-incision lenticule extraction(SMILE)with different corneal cap thicknesses on postoperative astigmatism and short-term visual quality of patients with myopic astigmatism.METHODS: A total of 54 patients(108 eyes)with myopic astigmatism who underwent SMILE from June 2020 to June 2022 in our hospital were selected for the prospective controlled study, and patients were randomly assigned into two groups, with 27 cases(54 eyes)each. The corneal cap thickness design was 110 μm for the group A and 120 μm for the group B, while other operation parameters were consistent. Additionally, the uncorrected visual acuity(UCVA), spherical equivalent(SE), stiffness parameter A1(SP-A1), visual quality and vector parameters at baseline, 1 d,1 wk and 1 mo after surgery were compared between two groups.RESULTS: There was a statistically significant difference in UCVA, SE, and SP-A1 between the two groups at various time points before and after surgery(all P0.05). The objective scattering index(OSI)of the group A was lower than that of the group B, while Strehl ratio(SR)of the group A was higher than that of the group B at 1 d after surgery(both P0.05).CONCLUSION: SMILE procedures with both 110 μm and 120 μm corneal cap thicknesses are safe and effective in correcting myopic astigmatism without affecting postoperative SE, astigmatism, SP-A1 or contrast visual acuity. Whereas 110 μm corneal cap thickness results in faster early postoperative visual recovery and better early visual quality than 120 μm.

AIM: To investigate the early visual quality after 0.05 D interval spherical lens optometry-guided small incision lenticule extraction(SMILE)for the correction of different degrees of myopia.METHODS: Retrospective study. A total of 200 cases(200 eyes)that underwent SMILE at the 989th Hospital of Joint Logistic Support Force from May to September 2023 were selected. The 0.05 D optometry was used to measure diopter. According to the preoperative spherical equivalent(SE), they were divided into low-to-moderate myopic group(>-6.0 D)and high myopic group(≤-6.0 D), with 100 eyes in each group. The total high-order corneal aberration(HOA), spherical aberration, coma and trefoil aberration were compared between the two groups preoperatively and at 6 mo postoperatively, and the quality of vision questionnaire was completed.RESULTS: The HOA, spherical aberration and vertical coma aberration in the two groups at 6 mo after operation were significantly higher than those before operation(all P

AIM: To compare the clinical effect of small incision lenticule extraction(SMILE)and implantable collamer lens(ICL)implantation on efficacy, safety and visual quality in patients with high myopia complicated with low astigmatism.METHODS: Retrospective study. A total of 80 cases(159 eyes)of high myopia and low astigmatism treated in the hospital from January 2021 to January 2022 were included, and they were divided into 46 cases(91 eyes)in SMILE group and 34 cases(68 eyes)in ICL implantation group by means of different surgical methods. The spherical equivalent, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), higher order aberrations of cornea and optical quality index, effectiveness and safety index were compared between the two groups before surgery and at 3 and 6 mo after surgery, and the surgical complications were counted.RESULTS: The spherical equivalent, UCVA and BCVA of both groups were all improved at 6 mo postoperatively(all P0.05). The root mean square values of total higher order aberration, spherical aberration, coma, vertical coma and horizontal coma in the SMILE group were higher than those in the ICL implantation group, and Strehl ratio(SR)in the ICL implantation group was higher than that in the SMILE group at 3 and 6 mo after surgery(all P

Since the first intraocular lens(IOL)was implanted by Harold Ridley in 1949 and the widespread use of depth-of-focus extended intraocular lens(EDOF IOL)clinically, the IOL has been constantly updated and developed, aiming to provide patients with good postoperative visual quality. The residual astigmatism is one of the important factors affecting the postoperative visual quality of cataract patients, 35%-40% of cataract patients have astigmatism of 1.00 D, and 19%-22% have astigmatism of 1.50 D. Therefore, it is important to understand the inclusiveness of EDOF IOL for astigmatism, so that the right IOL can be selected for the patient. This article summarizes the inclusiveness of different types of EDOF IOL for astigmatism and their advantages and disadvantages, with the expectation that it will provide a reference in selecting EDOF IOL for patients with different residual astigmatism.

AIM: To analyze the changes of the dominant eye in myopic patients after small incision lenticule extraction(SMILE)and its effect on visual quality.METHODS: Prospective clinical study. A total of 140 patients(280 eyes)who underwent SMILE operation to correct myopia in the First Affiliated Hospital of Xinjiang Medical University from June to December 2022 were selected. They were divided into dominant eye transformation group(46 cases, 92 eyes)and non-transformation group(94 cases, 188 eyes)according to whether the dominant eye transformation occurred during the follow-up in postoperative 3 mo. The uncorrected visual acuity(UCVA)of the two groups was evaluated, the subjective visual quality was evaluated by the quality of life impact of refractive correction(QIRC)scale, and the objective visual quality was evaluated by measuring the high-order aberrations of the whole eye before and at 1 and 3 mo after surgery.RESULTS: Before SMILE, the right type of dominant eye was 105 cases, left-type was 35 cases. There were 46 cases had change at 1 mo postoperatively, and there was no new change at 3 mo after operation than 1 mo after operation. There was no significant difference in UCVA and QIRC scale score between the two groups preoperatively and at 1 and 3 mo postoperatively(P>0.05). Comparison of the dominant eye between the two groups: the total higher-order aberrations and spherical aberrations at 3 mo postoperatively were significantly higher than those in the non-transformed group(P=0.030, 0.046); Comparison of the non-dominant eye between the two groups: trefoil in the transformed group at 1 mo postoperatively was significantly higher than that in the non-transformed group(P=0.008). The binocular difference of trefoil in the transition group was significantly higher than that in the non-transition group at 1 mo after surgery(P=0.022), with no differences in the rest parameters.CONCLUSION: Some patients may experience a change in the dominant eye after SMILE surgery, with no significant impact on subjective visual quality. The decrease of objective visual quality in the early postoperative period may be an associated factor in the dominant eye transformation.

AIM:To compare the corneal refractive power and visual quality after three kinds of corneal refractive surgery: laser subepithelial keratomileusis(LASEK), transepithelial photorefractive keratectomy(TransPRK)and femtosecond laser assisted in situ keratomileusis(FS-LASIK).METHODS: Retrospective study. A total of 232 patients(464 eyes)who underwent elective corneal refractive surgery in our hospital from January 2021 to December 2022 were selected as the study subjects. They were divided into the LASEK group of 70 cases(140 eyes), TransPRK group of 76 cases(152 eyes), and FS-LASIK group of 86 cases(172 eyes)according to the different surgical choices made by the patients. Uncorrected visual acuity(UCVA), visual quality, biomechanical stability, tear film break-up time(BUT), Schirmer Ⅰ test(SⅠt)and quality of life were compared among the three groups at 1 and 3 mo postoperatively.RESULTS: The UCVA of the three groups significantly improved at 1 and 3 mo postoperatively, the total high-order aberrations, spherical aberration, horizontal coma, and vertical coma of the entire cornea were significantly increased, while the biomechanical stability in all three groups were significantly reduced(all P0.05).CONCLUSION:In the treatment of ametropia, LASEK, TransPRK and FS-LASIK all have certain effects, and have similar results in improving UCVA and increasing visual quality. However, TransPRK and LASEK have more stable biomechanical properties than FS-LASIK, and have better efficacy in improving patients' quality of life.

In recent years, the combined surgery of phacoemulsification, intraocular lens implantation, and goniosychialysis has gradually emerged as a primary and effective approach in treating primary angle-closure glaucoma with cataracts. However, with the continuous progress of medical technology, postoperative intraocular pressure control is no longer the sole pursuit. Patients increasingly aspire to achieve higher postoperative visual quality. In order to ensure that patients attain a better refractive status and higher visual quality postoperatively, it is essential to minimize the negative impact caused by primary angle-closure glaucoma. This involves personalized selection of different intraocular lenses or calculation formulas,etc. Evaluation metrics for visual quality encompass visual acuity, contrast sensitivity, higher-order aberrations, subjective perception, etc. Therefore, this paper provides a comprehensive review of postoperative refractive shift, higher-order aberrations, contrast sensitivity and their influencing factors, and the selection of intraocular lenses for patients undergoing combined surgery for primary angle-closure glaucoma with cataracts.

AIM: To explore the effects of femtosecond laser-assisted cataract surgery combined with intraocular lens implantation(FLACS-IOL)on postoperative deviation rate of multifocal intraocular lens(MIOL)and visual quality in cataract patients.METHODS: In the prospective study, 95 patients with cataract(108 eyes)who underwent MIOL implantation in the hospital between January 2021 and December 2022 were enrolled. According to different surgical methods, they were divided into FLACS group(51 cases, 56 eyes)and Phaco group(44 cases, 52 eyes). The operation time, incision diameter of anterior capsule, effective phaco time(EPT), cumulative dissipated energy(CDE), uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), eccentricity distance of IOL and deviation rate at 3 mo after surgery, total high order aberration(HOA), Trefoil and coma under 3 mm pupil were compared between the two groups.RESULTS: The operation time in the FLACS group was significantly shorter than that in the Phaco group, EPT and CDE were significantly lower than those in the Phaco group(all P0.05). At 1 wk, 3 mo after surgery, UCDVA in the FLACS group was better than that in the Phaco group(all P0.05).CONCLUSION: FLACS-IOL can effectively reduce deviation rate of IOL and obtain better visual quality in cataract patients.

AIM: To investigate the visual quality of LENTIS Comfort Toric intraocular lens implantation in cataract surgery.METHODS: A retrospective controlled clinical study was conducted on 40 patients(40 eyes)who received phacoemulsification combined with intraocular lens implantation assisted by digital navigation, with LENTIS Comfort Toric(MF15T)implanted in group A(24 eyes)and monofocal Toric intraocular lens implanted in group B(16 eyes). The visual acuity at different distances, the postoperative astigmatism center of mass value, the lens loss rate, the change of defocus curve and the stability of intraocular lens were observed at 3mo after surgery.RESULTS: There were no serious complications in both groups, and there was no significant difference in distance vision between group A and group B at 3mo after surgery(P>0.05); the visual acuity and near vision in group A were significantly better than those in group B(P0.05); the defocus curve of group A peaked at +0.50 and -1.75D at 3mo after surgery, forming plateau and gently declining, while group B showed a steep decline after peaks at +0.25 and -0.25D. One eye(4%)in group A had the axial rotation of intraocular lens greater than 10° at 1d after surgery; In group B, 6 eyes(38%)had axial rotation of intraocular lenses greater than 10°, 2 eyes(33%)rotated clockwise, and 4 eyes(67%)rotated counterclockwise. No intraocular lens displacement occurred in either group.CONCLUSION: Both kinds of intraocular lenses can correct astigmatism, among which LENTIS Comfort Toric intraocular lens can provide personalized choices for people with cataract and astigmatism, solve astigmatism and obtain full visual acuity at the same time, with low incidence of postoperative optical interference, better stability, high visual quality and satisfaction.

AIM: To evaluate the effect of anterior capsule polishing on visual quality after phacoemulsification.METHODS: Prospective randomized control study. A total of 65 patients(73 eyes)with age-related cataract who underwent phacoemulsification combined with intraocular lens(IOL)implantation in the Emergency General Hospital between November 2021 and June 2022 were included. These patients were randomly assigned to two groups, with one group(anterior polishing group)underwent anterior and posterior capsule polishing(30 cases, 35 eyes), while the other(control group)receive routine posterior capsule polishing(35 cases, 38 eyes). Best corrected visual acuity was observed at 1wk, 1, 3 and 6mo after operation. Area of anterior capsule orifice was measured at 3 and 6mo after operation. Meanwhile, posterior capsular opacification(P score), IOL tilt and decentration were recorded by Pentacam Scheimpflug system. In addition, wavefront aberration, Strehl ratio(SR)of point spread function(PSF)and modulation transfer function(MTF)were evaluated by OPD-Scan Ⅲ.RESULTS: At 1wk, 1, 3 and 6mo after operation, best corrected visual acuity in anterior polishing group is significantly better than that of control group(P0.05). At 3mo follow-up, no significant differences in IOL tilt and wavefront aberration were measured between two groups either(P>0.05). However, IOL tilt [(1.65±0.60)° vs.(2.34±0.43)°, P

AIM: To investigate the short-term visual quality outcomes after femtosecond laser small incision lenticule extraction(SMILE)and evolution implantable collamer lens(EVO-ICL)implantation for the correction of moderate myopia.METHODS: Prospective control study. A total of 51 cases(51 eyes)with moderate myopia who underwent SMILE or EVO-ICL implantation surgery at Weifang Eye Hospital from April 2021 to February 2022 were selected. They were divided into SMILE group(30 patients, 30 eyes)and EVO-ICL group(21 patients, 21 eyes)according to the surgical methods. The changes of visual acuity [uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA)], diopter [spherical equivalent(SE)] and related parameters of optical quality analysis system(OQAS Ⅱ)were observed before surgery and at 1wk, 1 and 3mo after surgery, and the quality of vision(QoV)questionnaire was completed.RESULTS: At 3mo after surgery, the safety index(postoperative CDVA/preoperative CDVA)of SMILE gruop and EVO-ICL group were 1.20(1.00, 1.20)and 1.20(1.00, 1.38), respectively, the efficacy index(postoperative UDVA/preoperative CDVA)were 1.00(1.00, 1.20)and 1.00(1.00, 1.20), respectively, and the percentage of SE within ±0.50D was 87% and 100%, respectively. In SMILE group, the objective scattering index(OSI)was increased after surgery, while modulation transfer function cutoff frequency(MTF cutoff), contrast visual acuity(VA)100%, and VA20% at 1wk and 1mo after surgery, and Strehl ratio(SR)and VA9% at each time point after surgery were all decreased compared with those before surgery(all P0.05). The most common visual symptoms after SMILE and EVO-ICL implantation were visual haze and halos, respectively.CONCLUSION: Both SMILE and EVO-ICL implantation have good safety, efficacy and predictability in the short term after the correction of moderate myopia. Both groups had visual symptoms after surgery, but the overall satisfaction of patients was high. Furthermore, EVO-ICL implantation has better objective visual quality performance.

AIM: To compare the visual quality between smart pulse technology-assisted(SPT)transepithelial photorefractive keratectomy(TransPRK)of 1 050Hz ablation frequency and small incision lenticule extraction(SMILE)for myopia and astigmatism.METHODS: A total of 138 cases(248 eyes)who received corneal refractive surgery in the Eye Hospital of Chengdu University of TCM were enrolled from July 2020 to January 2021. The patients were divided into TransPRK group(64 cases, 123 eyes)and SMILE group(74 cases, 125 eyes)according to the surgical method. The follow-up duration was 6mo. Strehl ratio(SR)and high-order aberration at 6mm pupil diameter measured by Sirius anterior segment integrated analyzer and LogMAR visual acuity were recorded at different preoperative and postoperative time points.RESULTS: The uncorrected visual acuity(UCVA)of TransPRK group was worse than SMILE group at 1wk and 1mo after surgery(all P

Corneal refractive surgery and intraocular collamer lens(ICL)implantation are the mainstream refractive surgery methods at present. Many studies have proved that ICL implantation can effectively improve the postoperative visual acuity of patients. ICL implantation has gained favor among refractive doctors and patients because of its multiple advantages. Excellent postoperative visual acuity and visual quality are the key factors to improve patients' satisfaction. In order to evaluate the subjective and objective visual quality of patients after operation and avoid complications, this article reviews the visual quality and postoperative complications after ICL implantation.

AIM: To explore the application effect of capsular tension ring(CTR)in phacoemulsification(Phaco)combined with intraocular lens(IOL)implantation for patients with high myopia, cataract and suspensory ligament relaxation.METHODS: Prospective study. A total of 80 patients(80 eyes)with high myopia, cataract and suspensory ligament relaxation who underwent Phaco combined with IOL implantation in the hospital between April 2020 and August 2021 were enrolled. According to random number table method, they were divided into CTR group(Phaco combined with CTR and IOL implantation)and control group(Phaco combined with IOL implantation), with 40 cases(40 eyes)in each group. The best corrected distance visual acuity(BCDVA), anterior capsule area, total IOL inclination and subjective visual quality before and after surgery were compared between the two groups.RESULTS: At 1, 3 and 6mo after surgery, BCDVA was improved(P

AIM: To compare the visual effect of patients with presbyopia corrected by bifocal(AtLisa tri 809MP)intraocular lens(IOL)and trifocal(AtLisa tri 839MP)IOL implantation.METHOD:A total of 40 patients(51 eyes)who underwent cataract phacomulsification surgery in our hospital were collected, and they were retrospectively analyzed and divided into group A and group B. The group A with 20 patients(25 eyes)implanted the bifocal 809MP IOL, while the group B with 20 patients(26 eyes)implanted the trifocal 839MP IOL. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and the defocus curve of the patients in two groups were measured at 3mo after surgery. Additionally, statistical analysis was carried out through satisfaction questionnaire.RESULT:There were no significant differences in the UDVA and best corrected visual acuity(BCVA)between the two groups at 3mo after surgery(P>0.05). In group B, the UIVA(80cm)was significantly better than that in group A(P0.05). The defocus curve analysis at 3mo after surgery revealed that the group A had double peaks at 0D and -3D; while the group B had double peaks at 0D and -2.5D. Patients in the two groups showed different degrees of halo, glare and other optical manifestation, but the overall satisfactions and the near vision satisfactions were higher.CONCLUSION: Two types of IOL can provide patients with full range of vision that including both near and far distance visual acuity. Both of the AtLisa tri 839MP IOL and 809MP IOL can provide good near vision, while the trifocal IOL is more suitable for intermediate distance vision.

AIM: To explore that double steep axial transparent corneal incision can effectively minimize corneal astigmatism and high-order aberration(HOA)in cataract patients with moderate to low degree corneal astigmatism, as well as improve postoperative visual quality.METHODS: A total of 60 cataract patients diagnosed with moderate to low corneal astigmatism in our hospital from October 2020 to July 2021 were randomly divided into group A(normal 135° incision, 30 cases)and group B(double steep axial transparent corneal incision, 30 cases). The uncorrected visual acuity(UCVA), astigmatism, astigmatism vector decomposition, polar keratometry(Polar K), second-order astigmatism, spherical, coma and trefoil aberration within 3mm of the central pupil were compared at 1 and 3mo before and after surgery.RESULTS: UCVA of group A and group B at 1 and 3mo after surgery was significantly higher than that before surgery(P0.05). The corneal astigmatism of group A at 1 and 3mo postoperative were not significantly different from that before surgery(P>0.05).The mean corneal astigmatism of group B was 0.66±0.13 and 0.61±0.12D at 1 and 3mo after surgery, respectively, which was significantly lower than the preoperative value of 1.38±0.24D(P0.05). In group A, CJ0/CJ45 were both significantly different from those at 1 and 3mo before surgery(P0.05). The coma aberration of group B at 3mo after surgery was lower than that before surgery and group A.CONCLUSION: For cataract patients with moderate to low corneal astigmatism, there was no significant difference in postoperative UCVA and HOA between double steep axial transparent corneal incision and normal incision. However, compared with normal incision, double steep axial transparent corneal incision can improve postoperative visual quality by effectively reducing corneal astigmatism and coma aberration.

AIM: To compare the visual quality of patients with high myopia and cataract after the implantation of tecnis Symfony intraocular lens(IOL)and tecnis ZMB00 multifocal IOL.METHODS: A prospective nonrandomized controlled study was conducted on the patients with high myopia and cataract who underwent phacoemulsification combined with IOL implantation in the First Affiliated Hospital of Baotou Medical College from June 2020 to July 2021. According to the selected IOL, the patients were divided into 32 cases(32 eyes)in Symfony group and 31 cases(31 eyes)in ZMB00 group. The patients were followed up for 3mo after operation. Main outcome measures: comparison of spherical equivalent, naked eye and best corrected far vision(5m), middle(80, 60cm)and near(33cm)vision under naked eye, the best corrected far vision at 1 and 3mo after surgery and the defocusing curve, contrast sensitivity, IOL eccentricity and inclination at 3mo after surgery. Secondary outcome measures: residual astigmatism tolerance(90°, 180° axial position, positive and negative cylindrical mirror)and visual quality questionnaire at 3mo after surgery.RESULTS: There was no significant difference between the two groups in the comparison of naked eye, best corrected far vision and spherical equivalent at 1 and 3mo after operation(P>0.05). The middle vision under naked eye and best corrected far vision in Symfony group was better than that in ZMB00 group; Compared with the near vision under the naked eye and the best corrected far vision, the ZMB00 group was higher than that in the Symfony group(all P0.05). Residual astigmatism tolerance showed discomfort at +0.75D and -1.00D in the ZMB00 group and at +1.00D and -1.50D in the Symfony group, and the visual acuity was lower than 0.3LogMAR(all P

With the development of refractive cataract surgery,Toric intraocular lens(Toric IOL)has been widely used as a functional IOL in the clinical practice. The implantation of Toric IOL in cataract patients can effectively correct preoperative corneal astigmatism and reduce postoperative residual astigmatism, thus obtaining better uncorrected visual acuity and visual quality. Mild decentration, tilt and rotation of Toric IOL do not cause significant subjective discomfort in patients. However, a certain degree of decentration, tilt and rotation of Toric IOL can increase astigmatism and higher-order aberration, resulting in decreased visual acuity and visual quality. Based on relevant results at home and abroad, this article reviewed the influence of the decentration, tilt and rotation of Toric IOL on visual quality at both basic and clinical levels and discussed the existing problems and prospects.

AIM: To investigate the correlation between postoperative lens decentration and tilt and visual quality in eyes implanted with aspherical intraocular lens(IOL)by using a new anterior segment swept-source optical coherence tomography(OCT)CASIA2.METHODS: An observational study. A total of 90 eyes of 62 participants who underwent age-related cataract surgery at 1mo were included. Using CASIA2 by an experienced examiner, IOL tilt and decentration were obtained three consecutive times after mydriasis and the vector mean values were calculated. Double-pass optical quality analysis system(OQAS)and wavefront aberration instrument KR-1W were used for the visual quality measurements, including the total high-order aberration(tHOA), spherical aberration(SA), Coma, objective scatter index(OSI), modulation transfer function cut off frequency(MTF cut off)and Strehl ratio(SR)at 4 and 6mm pupil diameter.RESULTS: IOL decentration was positively correlated with SA(r=0.347, P=0.001)and OSI(r=0.343, P=0.002)at 4mm pupil diameter, and it was negatively correlated with MTF cut off(r=-0.244, P=0.032). There was no significant correlation between IOL decentration and tHOA, Coma and SR. IOL tilt was negatively correlated with MTF cut off(r=0.-345, P=0.002)and SR(r=-0.256, P=0.023)at 4mm pupil diameter, but it was not correlated with tHOA, SA, Coma and OSI. There were no significant correlations between the IOL decentration and tilt and tHOA, SA, Coma, MTF cut off and SR at 6mm pupil diameter.CONCLUSION: After aspherical IOL implantation in age-related cataract patients, IOL decentration was weakly correlated with SA at 4mm pupil diameter, while decentration and tilt were not significantly correlated with other higher-order aberrations. The decentration and tilt were weakly correlated with OSI value and MTF cut off value of the visual quality parameters. The results suggest that clinicians should pay more attention to higher-order aberrations and visual quality during precise cataract surgery.

AIM: To compare the visual quality in patients after implantation of extended-range-of-vision(Tecnis Symfony)intraocular lens(IOL)and zonal refractive(Lentis Comfort LS-313 MF15)IOL. METHODS: A prospective clinical study. Collecting 267 cataract patients(305 eyes)who underwent phacoemulsification combined with IOL implantation surgery in our hospital from January 2021 to December 2021,they were divided into the Symfony group(group A, 160 eyes)and MF15 group(group B, 145 eyes)according to the types of implanted IOL. Postoperative visual acuity were observed at 3mo and included uncorrected distance visual acuity(UDVA, 5m), uncorrected intermediate visual acuity(UIVA, 80 cm), uncorrected near visual acuity(UNVA, 40cm), defocus curve, modulation transfer function(MTF)and high-order aberrations(HOAs), including coma, spherical aberration and trefoil aberration, and conducted the Quality of Vision(QoV)questionnaire.RESULTS: There were no significant differences in the preoperative parameters in both groups(P>0.05). There was no significant difference between the UDVA and UNVA in groups A and B(P>0.05); The UIVA was higher in group A than in group B(P

AIM: The clinical outcomes of unilateral single-focal intraocular len(SIOL), contralateral implanted multifocal IOL(MIOL)and the SIOL was implanted in binoculus were compared.METHODS: There were 60 cases with 120 eyes age-related cataract patients in January 2019 to January 2021 underwent phacoemulsification and IOL implantation in Chengdu Aier Eye Hospital. The SIOL has been implanted in the dominant eyes, all patients were divided into three groups according to the types of IOL implanted in the contralateral non-dominant eyes, among them, there were 36 eyes of 18 cases in group A with non-dominant eyes implanted MIOL(SBL-3); 38 eyes of 19 cases in group B were implanted MIOL(SN6AD1)in non-dominant eyes. SIOL was implanted in all 46 eyes of 23 cases of control group. After operation at 3mo,the results of binocular vision and visual quality of the three groups were evaluated and compared.RESULTS: After operationat 3mo, there was no difference in the uncorrected distance vision and corrected distance vision, uncorrected medium vision and corrected near vision among the three groups(P

Femtosecond laser small incision lenticule extraction(SMILE)is one of the most advanced corneal refractive operations at present. Different from other traditional corneal refractive operations, SMILE achieves minimally invasive and valveless operation. Therefore, the evaluation of postoperative visual quality of SMILE also has its own characteristics, at present, the latest research at home and abroad has confirmed that the naked eye vision can be significantly improved and the refractive status is stable after SMILE. However, there are different understandings of the objective visual quality indexes and their influencing factors, such as higher-order aberration, modulation transfer function cut off(MTF cut off)and objective scatter index(OSI)after SMILE. This paper reviews the postoperative visual quality and its influencing factors after SMILE to provide clinical help.

AIM: To evaluate the visual quality of patients after modified design aspheric balance curve(ABC)with intraocular lens(IOL)implantation, and to analyze the influencing factors of clinical IOL selection and guide the patient's IOL selection plan. METHODS: A prospective case-control study was conducted in 67 patients(74 eyes)with simple cataract underwent phacoemulsification and foldable aspheric IOL implantation, and 23 eyes in the observation group were implanted with modified design IOL(HOYA Vivinex XY1 group), the control group was implanted with 51 eyes of traditional design IOL(Tecnis ZCB00 group with 27 eyes, IQ SN60WF group with 24 eyes). The uncorrected visual acuity, the best corrected visual acuity, total ocular spherical aberration(SA)and coma under different pupil diameters(3, 4, 5, 6mm), and different pupil diameters(3, 4, 5mm)were measured 1wk and 1mo after operation, the modulation transfer function(MTF)curve, objective scattering index(OSI), intraocular scattered light value Log(s)and contrast sensitivity were obtained. Statistical analysis was performed on the obtained data.RESULTS: The uncorrected visual acuity and best corrected visual acuity at 1wk and 1mo after operation in the three groups were significantly improved compared with those before operation, there was no significant difference among groups(P>0.05). The difference of total ocular spherical aberration was statistically significant among the three groups with 5 and 6mm pupil diameter 1wk after operation(P=0.045, 0.037)and there were differences among three groups in pupil diameter of 6mm at 1mo after operation(P=0.042). Comparing the total ocular coma aberration, there were differences among the three groups at 1wk and 1mo after the operation at the pupil diameter of 5 and 6 mm(P0.05), and there were no statistical differences in objective scattering index, intraocular scattered light value Log(s)and contrast sensitivity among the three groups(P>0.05).CONCLUSION:The improved design of the modified Vivinex IOL can reduce the total ocular spherical aberration and coma, improve the visual quality, and provide a new method for the selection of aspheric IOL.

AIM: To investigate the subjective visual quality, reading fluency and patient satisfaction after a unilateral or bilateral implantation of the Tecnis Symfony extended depth of focus intraocular lens(IOL)with cataract.METHODS: The retrospective analysis on the 48 patients(71 eyes)with cataract phacomulsification surgery in our hospital, which were randomly divided into two groups. The bilateral group with 23 patients(46 eyes)bilateral implanted the Symfony extended depth of focus IOL, the unilateral group with 25 patients(25 eyes)implanted the Symfony IOL in one eye and an aspherical monofocal IOL in the other eye. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured 3, 6mo after surgery. The contrast sensitivity, reading fluency, reading speed, patient satisfaction and the occurrence of complications were also observed.RESULTS: In the unilateral group, there were no significant differences in the UDVA and BCVA between an eye with the Symfony IOL and an eye with monofocal IOL 3mo after surgery(P>0.05). After 6mo of surgery, UDVA were significantly better than pre-operation in two groups, average visual acuity of LogMAR was under 0.1. There were no significant differences in UDVA, BCVA, UIVA and UNVA between two groups(P>0.05). The patients'far, intermediate, and near distances satisfaction were higher after 3mo of surgery. There were no statistically significant differences in spatial frequency contrast sensitivity between the two groups under photopic/mesopic conditions and mesopic with glare 6mo after surgery. The scores of satisfactions for reading fluency were better in the bilateral group than in the unilateral group(P>0.05). After 6mo, the reading speed of binocular group was slightly higher than the unilateral group(P0.05).CONCLUSION:The Symfony extended depth of focus IOL provides good far, intermediate, and near visual acuity in the bilateral group and the unilateral group, while maintaining the same level of visual quality. In both groups over 90% patients were spectacle independent. Symfony IOL has widely adaptability and highly predictability, patients can obtain better satisfactions for reading fluency and reading speed. It is more suitable for intermediate vision.

AIM: To analyze the errors of objective visual quality after the implantation of segmented refractive multifocal intraocular lenses in patients with age-related cataract. METHODS: In this retrospective study including 180 eyes of 116 patients with senile cataract, implantation of either Aspira-aA IOL or LS-313 MF30 IOL was performed in Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University. According to the implanted IOL, the patients were divided into the SIOL(Aspira-aA)group(61 patients, 96 eyes)and the MIOL(LS-313 MF30)group(55 patients, 84 eyes). Three months postoperatively, uncorrected distance visual acuity(UCDVA), best corrected distance visual acuity(BCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were assessed. Total higher-order aberrations(HOAt), internal higher-order aberrations(HOAi), corneal higher-order aberrations(HOAc), spherical aberration(SA), coma aberration(CA), trefoil aberration(TA), Strehl ratio(SR), average height of modulation transfer function(MTF AvgHeight)and dysfunctional lens index(DLI)were measured by iTrace visual quality analyzer(scanning diameter 3mm)three months postoperatively. RESULTS: Three months postoperatively, there was no statistically significant difference between the two groups in UCDVA and BCDVA(t=-0.789, -0.815; all P>0.05). UCIVA and UCNVA in the MIOL group were better than those in the SIOL group, with statistically significant difference(t=1.971, 3.215; all P0.05). HOAt, HOAi, coma aberration and trefoil aberration were larger in the MIOL group than those in the SIOL group(t=-2.518, -2.926, -2.859, -3.128; all P

AIM: To observe the early visual quality of the tri-focal and the mono-focal intraocular lens(IOLs)implantation in patients with age-related cataract, under comparison and analysis.METHODS: A retrospective research design. Totally 168 eyes of 119 age-related cataract patients who underwent cataract phacoemulsification combined with tri-focal and mono-focal IOLs implantation surgery in the cataract department from June 2018 to January 2021 were enrolled. In tri-focal and mono-focal group, 61 eyes of 44 cases and 107 eyes of 75 cases. One month after phacoemulsification combined with IOLs implantation, visual acuity, visual quality and contrast sensitivity were inspected. All data were under statistical analysis.RESULTS: On LogMAR uncorrected distance visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), best corrected distance visual acuity(BDVA), distance corrected intermediate visual acuity(DIVA), distance corrected near visual acuity(DNVA), tri-focal group were extremely better than mono-focal group(all P0.05).CONCLUSION: Tri-focal IOLs can provide a full range of relatively better vision and visual quality in patients after age-related cataract phacoemulsification combined with IOLs implantation, and perform well under different conditions.

AIM: To observe the visual quality after implantation of regional refractive multifocal intraocular lens(MIOL)SBL-3. METHODS: A retrospective and controlled study. Fifty-seven cataract patients(68 eyes)in our hospital from September 2019 to July 2020 were enrolled. Totally 33 cases(36 eyes)received regional refractive MIOL SBL-3(SBL-3 group), while 24 cases(32 eyes)received aspheric single focal intraocular lens(SIOL)ZCB00(ZCB00 group). Uncorrected and corrected distance, middle and near visual acuity, defocus curve, OPDⅢ objective visual quality, the quality of vision(QoV)questionnaire, patient satisfaction and spectacle independence were evaluated 3mo postoperatively.RESULTS: No significant differences were found between the SBL-3 group and the ZCB00 group in terms of LogMAR value of corrected and uncorrected distance visual acuity(UDVA)at 3mo after the operation(0.13±0.09 vs 0.10±0.08, 0.06±0.06 vs 0.08±0.08, all P>0.05)and the UDVA was significantly improved compared with that before the operation(P

AIM: To explore the effect of different energy parameters of femtosecond laser small incision lenticule extraction(SMILE)on stage Ⅰ opaque bubble layer(OBL)and visual quality. METHODS: A retrospective analysis of the clinical data of 216 patients(432 eyes)who came to our hospital for SMILE surgery from July 2018 to December 2019. According to whether stage Ⅰ OBL occurred, they were divided into OBL group(42 eyes)and non-OBL group(390 eyes). The age, visual acuity parameters, corneal parameters, microlens parameters and energy parameters were compared between the two groups, and multivariate regression analysis was used to analyze the relationship between the difference in energy settings and the OBL of stage Ⅰ. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), and modulation transfer function cut-off spatial frequency(MTFcut-off), Strehl Ratio(SR)and Objective Scattering Index(OSI)with energy parameters of 130, 135, 140, 145, and 150 nJ before and 1mo after surgery were compared. The correlation between energy parameters and stage Ⅰ OBL, UCVA, BCVA, MTFcut-off, SR, OSI were analyzed. RESULTS: Multivariate regression analysis showed that the energy setting with a difference of 5nJ did not show an association with stage Ⅰ OBL. In the different energy parameter groups, LogMAR UCVA, MTFcut-off, and OSI at 1mo after surgery were improved compared with preoperatively(P

AIM: To explore the effects of femtosecond laser-assisted in situ keratomileusis(FS-LASIK), topography guided LASIK(TG-LASIK)and small incision lenticule extraction(SMILE)on postoperative visual quality and higher-order aberrations(HOA)in patients with refractive errors.METHODS: A total of 296 patients(586 eyes)with simple myopia or myopic astigmatism who were admitted to refractive center of the hospital between December 2019 and February 2020 were enrolled. Under the premise of determining surgical indications, the patients chose to undergo FS-LASIK, TG-LASIK and SMILE voluntarily. Among them, there were 95 cases(189 eyes)in FS-LASIK group, 104 cases(205 eyes)in TG-LASIK group and 97 cases(192 eyes)in SMILE group. The data such as visual acuity, diopter, corneal topography, HOA and contrast sensitivity were collected before and at 6, 12mo after surgery.RESULTS:The uncorrected visual acuity, best corrected visual acuity, spherical equivalent and spherical equivalent refraction at 6mo after surgery were better than those before surgery(P0.05). At 6, 12mo after surgery, regularity index of corneal surface and surface asymmetry index in TG-LASIK group were significantly lower than those in SMILE group and FS-LASIK group(P0.05). At 6, 12mo after surgery, total HOA, clover aberration and coma at 6mo spherical aberration in FS-LASIK group were significantly higher than those in TG-LASIK group and SMILE group(P

AIM: To present the visual quality and refractive outcomes obtained in small incision lenticule extraction(SMILE)refractive surgeries, and observe the follow-up of patients over 1a period.METHODS: Retrospective comparative analysis of 85 patients(85 eyes)were treated with SMILE between July and December 2019. Pre- and postoperative uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), spherical equivalent refraction(SE)were all observed, to evaluate the efficacy, safety and predictability after SMILE refractive surgery. Total corneal higher-order aberrations(HOAs), modulation transfer function cut-off(MTFcutoff), strehl ratio(SR), and objective scattering index(OSI)were evaluated. RESULTS: One year after SMILE refractive surgery, the efficacy index was 1.08, 84 eyes(99%)reached an UDVA as or over CDVA preoperatively, 22 eyes(26%)gained one line of CDVA than preoperatively. The safety index was 1.04, 59 eyes(69%)of the treated eyes had an unchanged CDVA postoperatively, 24 eyes(28%)gained one line of CDVA, 2 eyes(2%)gained two lines of CDVA. 85 eyes(100%)were all within ±0.50D. The pre-correction is highly related with the actual correction of SE(Y=0.9949X-0.0033; R2=0.9977). HOA, spherical aberration and coma were increased under pupil diameters of 6mm(all P

AIM: To study the effects of small-incision lenticule extraction(SMILE)and femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)on early postoperative corneal higher order aberrations(HOAs)and visual quality in patients with high myopia. METHODS:Totally 102 patients(204 eyes)with high myopia who underwent corneal refractive surgery between August 2018 and August 2020 in the hospital were selected as study subjects for the prospective study, and they were randomly divided into SMILE group(51 cases, 102 eyes)and FS-LASIK group(51 cases, 102 eyes). The postoperative visual acuity, corneal HOAs and objective visual quality were compared between the two groups, and the correlation between corneal HOAs and objective visual quality was analyzed. RESULTS: At 1mo after surgery, the spherical equivalent degrees in SMILE group and FS-LASIK group were significantly reduced(P0.05). The corneal HOAs in the two groups were significantly increased(P

AIM: To evaluate the visual quality between the Tecnis Symfony extended depth of focus intraocular lens(IOL)and Zeiss trifocal IOL(At Lisa tri 839 MP)implantation.METHODS: Forty-two patients(53 eyes)who underwent cataract phacomulsification with IOL implantation from Jan. 2019 to Dec. 2020 were randomly divided into group A and group B according to the type of implanted IOL. The group A with 22 patients(29 eyes)implanted the Tecnis Symfony extended depth of focus IOL, the group B with 20 patients(24 eyes)implanted Zeiss trifocal IOL. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured after 3mo of surgery. The defocus curve, the quality of life and the occurrence of complications were also observed.RESULTS: The visual acuity was significantly improved in both groups after 3mo of surgery. There were no significant differences in the UDVA(5m), UIVA(80cm)and BCVA(5m)between the two groups(P>0.05). In group B, the UIVA(60cm)and UNVA(40cm)were better than in group A(all P0.05), but the near visual acuity at -2.5D and -3.5D in group B were significantly higher than in group A(all P

AIM: To study the postoperative optical zone decentration and visual quality by taking visual axis corneal reflect point(VACRP)and corneal vertex(CV)as the ablation center, exploring the femtosecond laser small incision lenticule extraction(SMILE).METHODS: Prospective randomized controlled trial. Totally 70 myopic patients(140 eyes)who underwent SMILE surgery in our hospital from May to June 2020 were randomly divided into two groups, 68 eyes of 34 cases took the VACRP as the ablation center(VACRP group), and 72 eyes of 36 cases took the CV as the ablation center(CV group). The visual acuity, refractive diopter, offset from corneal ablation center, and high-order corneal aberrations were observed before and 3mo after surgery. RESULTS: Three months after operation, there was no difference in uncorrected visual acuity, best corrected visual acuity and refractive diopter between the two groups(P>0.05). The ablation center deviation in CV group(0.20±0.13mm)was less than that in VACRP group(0.27±0.14mm, P

AIM: To evaluate the changes of early visual quality of patients with high myopia after small incision lenticule extraction(SMILE)and femtosecond assisted laser in situ keratomileusis(FS-LASIK)by the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and Pentacam corneal topography.METHODS: A prospective non-randomized controlled study was conducted among 148 eyes of 74 patients with high myopia. These patients were treated by the same surgeon in our hospital from March 2020 to September 2020. According to their wishes, 86 eyes with 43 patients were treated with SMILE and 62 eyes with 31 patients were treated with FS-LASIK. The uncorrected visual acuity(UCVA), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), objective scattering index(OSI), predicted visual acuity values(VA 100%, VA 20%, VA 9%), high-order aberration(HOA), horizontal aberration(Z 13), vertical coma(Z -13)and spherical aberration(Z 04)preoperatively, 1 and 7d postoperatively were collected and analyzed.RESULTS:There was no statistical significance in preoperative age, spherical equivalent(SE), UCVA, MTF cut off, SR, OSI, VA 100%, VA 20%, VA 9%, HOA, Z 13, Z -13 and Z 04(P>0.05). The OSI of the SMILE group was higher than the FS-LASIK group at postoperative 1d(2.3±2.1 vs 1.8±1.1). The difference in OSI between the two groups was not statistically significant at postoperative 7d(1.2±0.7 vs 1.3±0.7). The HOA and Z04 in the FS-LASIK group were higher than the SMILE group at postoperative 1d and 7d(P0.05).CONCLUSION:FS-LASIK is easier to introduce corneal high-order aberration and spherical aberration in the early postoperative period, while SMILE with 2mm incision only introduces higher scatter at postoperative 1d. Therefore, SMILE can obtain better visual quality than FS-LASIK in the early postoperative period among patients with high myopia after corneal refractive surgery.

AIM:To evaluate the visual quality of different types of cataracts by double-pass optical quality analysis system(OQAS).METHODS: A cross-sectional study was conducted. Totally 30 age-related cataract patients(30 eyes), which were aged group, with an average age of 71.69±3.79 years, thirty patients(30 eyes)with complicated cataract were in the complicated group with an average age of 61.00±4.56 years and 30 normal patients(30 eyes)were in the normal group, with an average age of 65.34±4.06 years old, both of which with naked eye vision(UCVA)≤0.5, and from June 2019 to June 2020 in the eye Center of Renmin Hospital of Wuhan University were collected. The ocular surface and optical quality examination on the patient's visual quality, including anterior chamber depth(ACD), ocular axis(AL), IOP, corneal curvature(K), objective scattering index(OSI), MTF cut off frequency(MTF cut off), Sterl ratio(SR), contrast sensitivity VA100%, VA20%, VA9% and other visual quality were operated by the same doctor. RESULTS: Compared with glaucomatous cataract, the MTF cut off of uveitis cataract was lower(P=0.025), but higher than that of fundus cataract(P=0.013), and diabetic cataract(P=0.001). The MTF cutoff value of glaucomatous cataract was higher than that of fundus cataract(P=0.013), and diabetic cataract(P=0.007); the MTF cutoff of fundus cataract was higher than that of diabetic cataract and there was significant difference(P=0.010).CONCLUSION: There are some differences in the ocular surface and visual quality parameters of each subtype of complicated cataract, especially MTF cut off, so we should paid attention to the cataract types before surgery.

The effectiveness, safety, stability and predictability ofsmall incision lenticule extraction(SMILE)have been proven by numerous studies. The postoperative visual quality has aroused more and more concern from the public. Recently, the influencing factors of visual quality after SMILE have been continuously reported, which offer further support for improving postoperative visual quality. This review mainly demonstrates the factors related to perioperative period that influence visual quality after SMILE performed on eyes of myopia or myopia astigmatism.

AIM: To analyze the influence of trifocal lens(AT LISA tri 839MP), Lenstec SBL-3 intraocular lens(IOL)and T SPHERIS 209M monofocal IOL implantation on vision and visual quality of patients with age-related cataract(ARC). METHODS: Totally 114 patients(114 eyes)with ARC undergoing elective surgical treatment in the hospital between October 2018 and April 2019 were enrolled in the prospective clinical study. They were divided into LISA tri group, SBL group and monofocal group with 38 cases(38 eyes)in each group. They were treated with trifocal IOL(AT LISA tri 839MP), Lenstec SBL-3 IOL and CT SPHERIS 209M monofocal IOL, respectively. The corneal endothelium, vision and visual quality before operation and 3mo after operation were compared. RESULTS:Three months after operation, no significant changes in corneal endothelial cell density(ECD), central corneal thickness(CCT)and the proportion of hexagonal cells in the three groups compared with preoperation(P>0.05), while the uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)were significantly improved(P

AIM:To review the objective visual quality after multifocal intraocular lens implantation.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%).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 \〖MD=0.66, 95% CI(0.42-0.90), PMD=-1.94, 95% CI (-5.58-1.70), P=0.30\〗, SR\〖MD=0.00, 95%CI (-0.02-0.02), P=0.87\〗, OV100% \〖MD=-0.02, 95%CI(-0.14-0.11), P=0.76\〗, OV20% \〖MD=-0.03, 95% CI(-0.14-0.08), P=0.60\〗, OV9% \〖MD= -0.01, 95% CI (-0.09-0.07), P=0.82\〗.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.

AIM: To contrast the visual acuity and visual quality after implantation of regional refraction multifocal IOL and aspheric unifocal IOL.METHODS: The study enrolled 82 cases(96 eyes)of age-related cataract patients, underwent phacoemulsification surgery in our hospital. According to the intraoperative intraocular lens implantation type, they were divided into two groups: the observation group(46 cases, 53 eyes, implanted with Oculentis MF30 regional refractive multifocal IOL)and the control group(36 cases, 43 eyes, implanted with ADAPT AO aspherical unifocal IOL). The total visual acuity and visual quality 3mo after operation were compared between the two groups. RESULTS: Three months after surgery, compared with the control group, the observation group had significantly improved near and middle vision, significantly increased contrast sensitivity, significantly increased modulation transfer function cutoff frequency, Strehl ratio, objective scatter index and OQAS values, significantly decreased VF-12-CN score(38.16±4.05 vs 45.72±4.69), and significantly increased desorption rate score(11.38±1.04 vs 9.23±0.87)and surgical satisfaction score(3.57±0.36 vs 3.32±0.31)(P65 years old, illiteracy, uncorrected distant visual acuity of good eye ≥0.1(LogMAR), implantation of aspheric unifocal IOL are the influencing factors of the quality of life of cataract patients. CONCLUSION: Compared with aspheric unifocal IOL, Oculentis regional refraction multifocal IOL can provide good overall vision in the short term after operation, and the contrast sensitivity, visual quality, quality of life, glasses removal rate and satisfaction are significantly improved.

AIM: To evaluate the early objective visual quality and vision related quality of life after implantation of posterior chamber phakic implantable collamer lens with a central hole(ICL V4c)for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and life quality questionnaire.METHODS: Totally 26 patients(44 eyes)with high myopia were enrolled in this research. The patients were all recieved ICL V4c implantation by the same surgeon in our hospital. The evaluation items included uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cell density(ECD), vault, objective scattering index(OSI), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), predicted visual acuity values(OV 100%, OV 20%, OV 9%)at contrasts of 100%, 20%and 9% and vision related quality of life questionnaire. All measurements were performed preoperative and 1wk, 1mo, 3mo postoperatively.RESULTS: Compared with preoperative BCVA, for the high myopia patients, the 1wk, 1mo and 3mo UCVA postoperative were better at all time points, and the differences were statistically significant(PPPP=0.790). Compared with preoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9%, the situation improved at postoperative 1wk, 1mo and 3mo, with statistical significance(PCONCLUSION: ICL V4c implantation is safe and effective in correcting high myopia. The objective visual quality and vision related quality of life of patients with high myopia was significantly improved after ICL V4c implantation in the early stage. The research laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.

AIM: To compare the effectiveness and safety of femtosecond laser-assisted cataract surgery(FLACS)with traditional cataract surgery in cataract patients with different axial lengths.METHODS: Patients with cataract surgery were divided into normal axis group(22mm≤ALRESULTS: The visual acuity of the patients in each group was improved(FLACS: t=8.29, 25.01, 19.23, all Pt=19.61, 18.76, 18.23, all PP=0.24, 0.25, 0.19). The postoperative strehl ratio value increased after operation in all groups expect for PHACO medium and long axis group, but the increase was significant only in normal axis group(P=0.011, 0.007). The corneal endothelial counts in the FLACS group were significantly lower than those before the operation(PPP>0.05).CONCLUSION: Both traditional cataract surgery and femtosecond laser-assisted cataract surgery can effectively improve the BCVA in various types of axis. Both surgical methods will cause damage to the corneal endothelium, but the difference is not obvious.

AIM: To compare the visual quality of bifocal(AT LISA 809MP)and trifocal(AT LISA tri 839MP)IOLs after implantation.METHODS: Retrospective study. A total of 49 eyes of 28 patients with cataract who underwent phacoemulsification combined with multifocal IOL implantation from March 2018 to February 2019 were collected. There were 30 eyes of 18 patients in the bifocal group, aged 40-85(mean 67.08±10.80)years. The trifocal group consisted of 19 eyes of 10 patients, aged 38-79(mean 62.21±14.50)years. All patients underwent visual quality analysis system(OQAS), defocus curve and other examinations.RESULTS: The near BCVA of the two focus groups was better than that of the three focus groups, and the medium UCVA and far BCVA of the three focus groups were better than those of the two focus groups(all PPCONCLUSION: Both bifocal and trifocal IOL implantation can achieve good uncorrected and near visual acuity and high visual quality, while trifocal IOL can achieve better intermediate visual acuity.

The adhesion of capsule and intraocular lens(IOL)is a common phenomenon after cataract surgery. At present, there are increasing researches on the adhesion between the capsule and IOL at home and abroad. In this paper, we will review the adhesion process between the capsule and IOL, morphology, related factors that affect the adhesion, and its influence on the visual quality.

AIM: To investigate the effect of fine capsule treatment on the visual quality of diffractive multifocal intraocular lens.METHODS: Ninety-eight patients(120 eyes)with DMIOL implanted in cataract Department of Hebei Eye Hospital from March 2017 to April 2018. They were randomly divided into A group and B group. 60 eyes in each group. Group A patients were treated with anterior and posterior capsular polishing and posterior continuous circular capsulorhexis, while in B group the fine capsule treatment was not performed. The UCDVA, UCIVA, UCNVA, visual quality, intraocular lens neutrality and PCO incidence were compared 6mo after operation.RESULTS: At 6mo after operation, UCDVA, UCIVA and UCNVA in group A were superior to those in group B. The difference was statistically significant(PPCONCLUSION: In order to enhance the stability of IOL and maintain the long-term transparency of the optic axis, we performed fine polishing of the anterior and posterior capsule and continuous circular capsulorhexis of the posterior capsule. These could improve the visual quality and satisfaction of patients after surgery.

AIM: To investigate the influence of orthokeratology on ocular surface and visual quality of intermittent exotropia with myopia. METHODS: Totally 60 patients(120 eyes)with intermittent exotropia and spherical equivalent ranging from -0.75 to -5.50D were numbered and divided into study group and control group according to random number table, which included 30 cases(60 eyes)of patients in each group. Two groups patients were intervened by orthopaedic training with prism for at least half of a year. In addition, the study group matched the night wearing corneal plastic lenses through the standardization of corneal plastic matching process, and observed continuously for at least half of a year. The before and after treatment strabismus, naked eye vision, best corrected visual acuity, fluoresce-in staining tear film rupture time(FBUT), diopter and visual quality between the two groups were compared. The rate of adverse reactions and complications between the two groups was compared to evaluate the safety. RESULTS: There was no significant difference in all before intervention indexes between the two groups(P > 0.05). Compared with that those of before intervention, in both groups, after treatment strabismus decreased, naked vision, best corrected vision and FBUT increased, diopter values reduced, and the proportion of patients with excellent visual quality increased. And the after treatment naked visual acuity, best corrected visual acuity, FBUT, diopter and visual quality in the study group were better than those in the control group(Pvs 10%, P=1.000). CONCLUSION: On the basis of triangular prism orthophotic training, the wearing of orthopaedic keratoplasty lenses can improve the tear film, refraction and visual quality of intermittent exotropia patients, and its safety is good, which is worthy of clinical application.

AIM: To assess the halo size and contrast sensitivity on different levels of myopia and to analyze their correlation.METHODS: Screening total 156 myopic patients aged 18 to 39 years old included in our hospital from March 2018 to March 2019. There were 49 subjects in high myopia group(SER>-6.00D), 54 in medium myopia group(-3.00DRESULTS: The size of glare halo in high myopia group was 106.27±25.89arc min, and 103.81±31.41arc min in medium myopia group, 102.87±32.24arc min in low myopia group, and there was no significant difference among three groups(F=0.297, P=0.825). There was no significant difference among three groups on contrast sensitivity under any different spatial frequencies(P>0.05). Correlation analysis showed a significant negative relationship between glare halo radius and contrast sensitivity at the c/d of 1.1, 2.2, 3.4, 7.1(rs=-0.302, rs=-0.308, rs=-0.383, rs=-0.257, all PP>0.05).CONCLUSION: Glare halo size had no relationship with SE but mid-frequency contrast sensitivity.

AIM: To observe the adolescents with different degrees of myopia who wore orthokeratology lens for 1a were visited and discuss the influence and safety of orthokeratology for curing the adolescent myopia.METHODS: Totally 158 cases of adolescent myopia(-1.00D to -8.00D)who all wore the same brand orthokeratology lens were selected from September 2016 to December 2017. Their visual quality, including aberration detection, subjective discomfort and visual quality questionnaire was observed for 1a. RESULTS: After wearing orthokeratology, the patients' total RMS decreased, while the RMSh, the RMS3(including coma)and the RMS4(including spherical aberration)increased. The higher of baseline degree, the higher incidence of subjective visual discomfort, and the difference between pre-wearing and after was not statistically significant in subjective visual quality score(P>0.05).CONCLUSION: The patients' objective visual quality decreased after wearing orthokeratology lens. However, the long-term observation revealed that the overall visual quality had no significant impact on lifelihood and learning, which indicates orthokeratology is a safe and effective mean of myopia curing.

AIM: To observe the postoperative visual quality and patient satisfaction of AT LISA Toric 909MP(909M)astigmatic corrected multifocal IOL and AT TORBI 709M(709M)astigmatic corrected single-focus IOL after phacoemulsification.METHODS: Patients with age-related cataract and corneal astigmatism(>1.0D)were enrolled and accepted phacoemulsification combined with implantation of intraocular lens(IOL)in our hospital during December 2017 and December 2018. Forty cases(56 eyes)were divided into two groups according to which IOL they chose, multiple focal astigmatism(909M)group included 23 cases(35 eyes), single focal astigmatism(709M)group included 17 cases(21 eyes). Three months postoperatively, the visual acuity, defocus curve, residual astigmatism degree, rotational stability of the IOL, postoperative visual quality analysis and patient satisfaction were evaluated.RESULTS: At 3mo postoperatively, uncorrected distance visual acuity(UDVA)and corrected distance acuity in the two groups were significantly improved(PCONCLUSION: Both of the 909M and 709M had good correction effect for cataract combined with astigmatism. It provided better rotational stability. In addition, 909M provided excellent distance, near visual outcomes, and acceptable intermediate vision. At the same time, it improved the spectacle independency and satisfaction of cataract patients combined with astigmatism.

AIM: To compare the visual quality between implantable collamer lens(ICL)implantation and FS-LASIK for correcting moderate and high myopia.METHODS: Prospective study. Choose in June 2018 to December 2018 for ICL implantation of 58 patients(116 eyes)and 48 patients(96 eyes)underwent FS-LASIK. The diopter, visual acuity and visual quality of the two groups before and after surgery were analyzed and compared.RESULTS: After 3mo operation, the degree of spherical mirror in the ICL group was higher than that in the FS-LASIK group(0.19±0.22D vs 0.09±0.29D, PP>0.05). The modulation transfer function cut off frequency(MTF cut off), objective scatter index(OSI)and OV9% were significantly better in the ICL group than in the FS-LASIK group, while the SR was lower than the FS-LASIK group. Compared with the former, the MTF cut off was significantly increased in the ICL group, the SR and OSI values were decreased, and the SR value was decreased in the FS-LASIK group(all PCONCLUSION: Both ICL implantation and FS-LASIK can effectively improve the visual acuity and diopter of patients, ICL implantation for patients with moderate and high myopia provides relatively good visual quality.