Background: To evaluate the correlating and predicting factors of visual outcome after implantation of newly\ndeveloped diffractive quadrifocal intraocular lens (IOL).\nMethods: A retrospective longitudinal study was conducted. Patients who underwent diffractive quadrifocal IOL\nimplantation with a follow-up period longer than six months and records of wavefront aberrometer within one\nweek perioperatively were enrolled. Accordingly, a total of 73 eyes from 73 patients were included. The\npostoperative distance and near visual acuity, ocular aberrations and postoperative symptoms were collected. The\ncorrelation and predictability between ocular aberrations and the postoperative visual outcome were evaluated.\nResults: The corrected distance visual acuity (CDVA) one month postoperatively was significantly better than the\npreoperative status, and insignificant improvement was found six months postoperatively. Preoperative Tracey\nrefraction spherical equivalent (TRSE), angle alpha, and spherical aberration (SA) were significantly correlated with\npostoperative CDVA and near corrected visual acuity (NCVA). For postoperative ocular aberrations, TRSE, angle\nalpha, and SA were significantly correlated with CDVA six months postoperatively and NCVA, while the trefoil,\ninternal higher order aberration (HOA) and total HOA were associated with NCVA. Preoperative angle alpha could\npredict all postoperative visual performances, while postoperative TRSE and angle alpha could predict the CDVA six\nmonths postoperatively and NCVA. A large angle alpha is associated with visual disturbance and dissatisfaction.\nConclusion: The angle alpha preoperatively and postoperatively was correlated with the postoperative vision and\ncould predict visual outcome in patients who had diffractive quadrifocal IOL implanted. Furthermore, the majority\nof ocular aberrations were also associated with certain postoperative vision.
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