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 P<0.05). No statistically significant differences were observed in HOAc and spherical aberration between the two groups(t=1.126, -0.995; all P>0.05). 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<0.05). Strehl ratio, MTF AvgHeight and DLI in the MIOL group were lower than those in the SIOL group, with statistically significant difference(t=2.8537, 2.014, 3.292; all P<0.05). The results of retinal letter, MTF AvgHeight and SR showed that HOAt and HOAi increased significantly in the MIOL group. The retinal spot diagram showed that coma aberration and trefoil aberration increased significantly with the addition of +3D spherical diopter.

CONCLUSION: Segmented refractive multifocal intraocular lens can provide excellent uncorrected distance, intermediate and near visual acuity. There may be errors in aberration measurement by iTrace visual quality analyzer after segmented refractive multifocal intraocular lenses implantation. The design of intraocular lens may lead to the postoperative increase in aberration and a decrease in objective visual quality.