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Visual function after cataract surgery in patients with an aspherical lens without spherical aberration
Author(s) -
PISELLA PJ
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.2431.x
Subject(s) - mesopic vision , spherical aberration , medicine , ophthalmology , intraocular lens , cataract surgery , contrast (vision) , intraocular lenses , pupil , glare , visual acuity , lens (geology) , optometry , photopic vision , optics , retinal , physics , materials science , layer (electronics) , composite material
Purpose To compare quality of vision in pseudophakic patients with customized‐asphericity intraocular lens (IOL) compared to patients with zero‐aberration IOL after a Micro‐Incision Cataract Surgery (MICS). Methods 26 patients (41 eyes) were divided into two groups: 24 eyes received a customized‐aspheric IOL in both eyes and 17 eyes received zero‐aberration IOLs. IOL asphericity was customized according to the preoperative corneal spherical aberration (SA) in order to obtain a total ocular SA close to +0 µm. We implanted either aspherical AcriSmart 36A® generating a ‐0,18 µm SA (for a 6 mm pupil diameter), or zero‐aberration AcriSmart 46LC®. Postoperative evaluations were conducted 6 months after MICS: refraction, best‐corrected visual acuity (BCVA), contrast sensitivities, point spread function (PSF), Modulation Transfer Function (MTF), objective depth‐of‐focus and ocular wavefront aberrations were analyzed. Results Postoperative BCVA was similar in both groups (‐0,021 ± 0,105 LogMAR for the custom group versus 0 ± 0,11 LogMAR, p=0,58). Mesopic contrast sensitivity was significantly better in the custom group at intermediate and high spatial frequencies (p<0.001). SA was significantly lower in the custom group (Z40 = 0,085 ± 0,07 µm vs 0,261 ± 0,09 µm, p<0.001) whereas no difference of preoperative corneal SA was noted. MTF cutoff frequency is lower in the reference group than in the custom group (p=0,008). The objective residual accommodative amplitude was lower in the custom group: 1,31 ± 0,54 D versus 2,25 ± 0,65 D (p=0,006). Conclusion Individual selection of IOL asphericity with a preoperative corneal spherical aberration measurement allowed control of final total amount of spherical aberration. Such a customization improved mesopic contrast sensitivity, and leads to better objective quality of vision.