Senile Cataract Clinical Trial
Official title:
Safety and Efficacy of Implantation of Two Multifocal Intraocular Lenses in the Treatment of Senile Cataract: a Randomized Controlled Clinical Trial
This trial is designed to compare the biocompatibility and long-term visual outcomes of the Tecnis Z9001 and Acri.LISA 366D multifocal IOLs used for the treatment of senile cataract. The aim is to provide a safer biomaterial for senile cataract treatment, achieving better postoperative visual quality and fewer complications.
History and current studies Aging-induced degenerative diseases are the leading cause of
senile cataract. Phacoemulsification with intraocular lens (IOL) implantation is a commonly
employed surgical technique for the treatment of cataract. A traditional IOL is spherical
and monofocal. Traditional monofocal IOL implantation allows cataract patients to obtain
good postoperative distance vision but loss of accommodation results in poor near vision.
Following monofocal IOL implantation, most patients still require the use of glasses.
Fortunately, the presence of multifocal IOLs solves this problem. Studies have shown that
aspheric IOLs with zero or negative spherical aberration can eliminate or reduce the
spherical aberration of the whole eye and can improve contrast sensitivity and night vision
compared with a spherical IOL.
As first reported in 1987 by Keatea et al., multifocal IOLs were introduced to provide
improved visual acuity, thus eliminating the need to wear glasses and improving the
patient's quality of life. Increasing evidence-based medicine evidences have shown that
multifocal IOLs are more adept to improving near vision than single-focus IOLs. To date,
various types of multifocal IOLs have been developed and according to different design
principles, clinically used multifocal IOLs have been divided into refraction type,
diffraction type and refraction/diffraction type. Introduced in 2002, the Tecnis Z9001
diffractive multifocal aspherical IOL (Abbott Medical Optics, CA, USA) is clinically proven
to give patients improved contrast vision and visual quality when compared with the common
IOL, although deficiencies include postoperative glare and reduced contrast sensitivity.
Emerging designs for multifocal IOLs aim to provide improvements in postoperative visual
quality. The Acri.LISA 366D multifocal aspheric IOL is a relatively novel
refractive/diffractive multifocal IOL that is different from traditional IOLs. Its unique
optical design improves the patient's full vision and reduces the incidence of light
scattering, glare and halo, which is expected to deliver better clinical outcomes. However,
its long-term clinical performance and the potential incidence of complications still need
further evaluation.
It is worth noting that as age increases, the increase in presbyopia, aberrations and lens
scattering reduces the compensation for corneal aberrations, thereby resulting in a decrease
in visual acuity and contrast sensitivity. Given this, ideal IOLs should have good
biocompatibility and good resolution with no spherical aberration.
Data collection, management, analysis, and open access Data collection Clinical data will be
collected and managed using an electronic data capture system. All data relevant to the
trial will be recorded in electronic case report forms that will be provided by the sponsor
personnel. The case report will be completed after the interview.
Data management After completion of follow-up and data confirmation, only the project
manager will lock the database. The locked data will be unable to be altered and will be
preserved for future reference by the Affiliated Hospital of Qinghai University in China.
Data analysis All data will be statistically analyzed by professional statisticians.
Open data Published data will be released at http://www.medresman.org.
Statistical analysis All data will be statistically analyzed by statisticians using SPSS
v19.0 software. Normally distributed measurement data will be expressed as mean ± standard
deviation, while non-normally distributed data will be expressed as quartiles and medians.
Categorical variables will be expressed as counts and percentages. Two-sample t-test or
Mann-Whitney U-test will be used for intergroup comparison of visual acuity and diopter. The
chi-squared test or Fisher's exact test will be used for intergroup comparison of incidence
of histocompatibility reactions between the implant and host tissues and the percentage of
complications. A value of P < O.05 will be considered statistically significant.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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