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 P<0.05); In the span of +1.0- -3.0D, the defocusing curve of Symfony group formed a plateau period of slow decline at 3mo after operation, and the visual acuity was better than 0.3LogMAR. And in the span of -1.0- -2.5D, the Symfony group was better than ZMB00 group(all P<0.05); The defocusing curve of ZMB00 group was bimodal, with peaks at 0 and -3.00D, and it was better than that of Symfony group in the span of -3.0- -3.5D(P<0.05). The contrast sensitivity(CS)of dark environment spatial frequency(3, 6, 12 and 18c/d)in Symfony group was better than that in ZMB00 group(all P<0.05). There was no significant difference in IOL eccentricity, inclination and visual quality scores between the two groups at 3mo after operation(P>0.05). 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<0.05). Postoperative discomfort such as glare and halo occurred in both groups to varying degrees, but most of the symptoms adapted or disappeared over time.

CONCLUSION: After cataract surgery for high myopia, both IOL have good capsular bag stability and centricity, and can provide excellent visual quality. With more advantages in middle vision and slightly insufficient performance in near vision, Symfony IOL can provide effective continuous visual range, while ZMB00 IOL is more suitable for those who have high requirements for near vision, and Symfony IOL shows better postoperative residual astigmatism tolerance.