PURPOSE To investigate the preoperative factors affecting visual acuity after the implantation of a diffractive multifocal intraocular lens. METHODS This study evaluated 774 eyes of 774 patients who underwent cataract surgery with TECNIS Multifocal ZLB00 lens (Johnson & Johnson Surgical Vision) implantation. Anterior segment optical coherence tomography (CASIA2; Tomey Corporation) was performed as a part of the preoperative eye examination. Sex, age, axial length, and CASIA2 parameters, such as crystalline lens diameter and lens tilt relative to the corneal topographic axis, were investigated. The eyes considered were classified into good (20/20 or better) or poor (worse than 20/20) far vision groups based on corrected distance visual acuity, and good (20/25 or better) or poor (worse than 20/25) near vision groups based on distance-corrected near visual acuity, respectively. Preoperative characteristics of both groups were compared to determine factors affecting postoperative visual acuity. RESULTS Multivariate logistic regression analysis revealed that older age (P < .001), a short axial length (P = .010), and a large lens tilt (P < .001) were associated with poor near vision. There was no significant difference between the two far vision groups. There was a significant negative correlation between lens tilt and axial length (r = -0.513, P < .001). CONCLUSIONS The results of this study suggest that age, axial length, and lens tilt to the corneal topographic axis may predict poor visual acuity after the implantation of a diffractive multifocal intraocular lens. Eyes with a short axial length tended to have a large degree of lens tilt and should be considered particularly carefully. [J Refract Surg. 2021;37(10):674-679.].

中文翻译：

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衍射多焦人工晶状体植入后影响视力的术前因素。

目的 探讨影响衍射多焦点人工晶状体植入术后视力的术前因素。方法 本研究评估了 774 名接受白内障手术并植入 TECNIS Multifocal ZLB00 晶状体（Johnson & Johnson Surgical Vision）的患者的 774 只眼。前段光学相干断层扫描 (CASIA2; Tomey Corporation) 作为术前眼科检查的一部分进行。研究了性别、年龄、轴长和 CASIA2 参数，例如晶状体直径和晶状体相对于角膜地形轴的倾斜度。根据矫正远视力，将考虑的眼睛分为好（20/20 或更好）或差（比 20/20 差）远视力组，和分别基于距离校正近视力的好（20/25 或更好）或差（比 20/25 差）近视力组。比较两组的术前特征，以确定影响术后视力的因素。结 两个远视组之间没有显着差异。透镜倾斜和轴向长度之间存在显着的负相关（r = -0.513，P < .001）。结论 本研究的结果表明，年龄、眼轴长度和晶状体相对于角膜地形轴的倾斜度可能预示着植入衍射多焦点人工晶状体后视力不佳。眼轴短的眼睛往往有较大的晶状体倾斜度，应特别仔细考虑。[J 屈光手术。2021;37(10):674-679.]。