Analysis of the effectiveness of refractive predictability and functional visual quality following dual-lens implantation in patients with high myopia

Objective. To evaluate the refractive accuracy, functional visual quality, and optical characteristics of bifocal lens implantation compared with monofocal lens implantation following phacoemulsification in patients with high myopia. Methods. A retrospectiveprospective comparative study included 100 patients (100 eyes) with an axial length > 28.00 mm. Patients were divided into two groups: Group 1 (n = 48) — dual-lens implantation in the capsular bag; Group 2 (n = 52) — mono-lens implantation. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), spherical equivalent, and cylindrical component were assessed during a follow-up period of up to 12 month. Results. 12 month after surgery, the mean spherical equivalent in the paired IOL group was −1.34 ± 1.2 D (target −1.09 D), and in the single IOL group, −0.48 ± 0.86 D (target −0.25 D). Best-corrected visual acuity (BCVA) reached 0.46 ± 0.26 logMAR (paired IOL) and 0.28 ± 0.18 logMAR (single IOL), p = 0.001. Refractive predictability within ±1.00 D of the target refraction was achieved in 88% of patients in the paired IOL group and 94.2% in the single IOL group (p = 0.29). Conclusions. Dual-lens implantation in high myopia provides acceptable refractive accuracy, stable visual function, and safety during the medium-term follow-up period. The paired IOL technique allows the optical power to be distributed between two lenses, potentially improving visual quality in patients with extremely long axial length and providing a greater depth of focus. Keywords: high myopia; dual-lens implantation; refractive predictability; higher-order aberrations

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