Abstract:AIM: To explore the effect of Kappa angle on changes in visual quality and stereoscopic acuity after regional refractive multifocal intraocular lens(MIOL)implantation in patients with high myopia complicated by cataract.
METHODS:A retrospective analysis was conducted on data from patients with normal Kappa angle and high myopia complicated by cataract treated at the hospital from January 2024 to January 2025. Patients were divided into two groups based on the median preoperative Kappa angle(0.182 mm): Group A(0RESULTS: A total of 100 patients(100 eyes)with normal Kappa angle and high myopia complicated by cataract were included. Patients were divided into Group A(52 patients, 52 eyes; 34 males, 18 females; mean age 52.35±3.16 y)and Group B(48 patients, 48 eyes; 31 males, 17 females; mean age 52.79±3.54 y). At 3 mo postoperatively, both groups showed increases in 9% contrast visual acuity(CVA), 20% CVA, 100% CVA, modulation transfer function cut off(MTF cut off), and strehl ratio(SR)compared with their respective preoperative values, while objective scatter index(OSI)decreased(all P<0.05). However, there were no differences between the two groups in BCDVA, BCIVA, BCNVA, 9%, 20%, and 100% CVA, OSI, MTF cut off, SR, total ocular higher-order aberrations, or total ocular spherical aberration at any postoperative time point(all P>0.05). The actual residual astigmatism in Group A was lower than that in Group B at 7 d, 1 and 3 mo postoperatively(all P<0.001). The proportion of eyes with near stereoscopic acuity <60″ was higher in Group A than in Group B, while the proportion of eyes with near stereoscopic acuity between 400″ and 3000″ was lower in Group A than in Group B(both P<0.05). Meanwhile, the incidence of visual disturbances in Group B was higher than that in Group A(P<0.05).CONCLUSION: The Kappa angle has no significant effect on visual acuity or objective visual quality in patients with normal Kappa angle and high myopia complicated by cataract after regional refractive MIOL implantation. However, patients with a larger Kappa angle exhibit higher postoperative residual astigmatism, worse near stereoscopic acuity, and a higher incidence of vision-related adverse symptoms.
