Abstract
Aims: To compare if there is an improvement in visual functions with age-related cataracts between patients receiving customized selected aspherical intraocular lens (IOL) implants and patients randomly assigned lenses. Methods: Ninety-four patients (94 eyes) with age-related cataracts were placed in experimental group or a group receiving randomly assigned (RA) lenses. All patients were undergone Pentacam corneal spherical aberration measurement before surgery; The targeted range for residual total spherical aberration after surgery was set to 0-0.3 μm in experimental group. Patients with a corneal spherical aberration ≤ 0.3 μm were implanted with a zero-spherical aberration advanced optics (AO) aspherical intraocular lens and patients with an aberration 0.3 μm received a Tecnis ZA9003 aspherical lens. RA patients were randomly implanted with an AO lens or a Tecnis ZA9003 lens. Three months after surgery total spherical aberration, photopic/mesopic contrast sensitivities, photopic/mesopic with glare contrast sensitivities, and LogMAR vision were measured. Results: Statistical analysis on LogMAR vision showed no significant difference between two groups (P = 0.308). The post-surgical total spherical aberration was 0.120 ± 0.097 μm and 0.158 ± 0.152 μm in the experimental and RA groups, respectively (P = 0.08). The mesopic contrast sensitivities at spatial frequencies of 6, 12 and 18 c/d in the experimental group were significantly higher than of the RA group (P = 0.00; P = 0.04; P = 0.01). The mesopic with glare contrast sensitivity in the RA group at a spatial frequency of 18 c/d was also significantly higher vs. the RA group (P = 0.02). Conclusion: Pre-surgical corneal spherical aberration measurement in cataract patients followed by customized selection of aspherical intraocular lens implants improved mesopic contrast sensitivities and mesopic with glare contrast sensitivities at high spatial frequencies, and thus is a superior strategy compared to the random selection of aspherical intraocular lens implants.
Highlights
Cataract phacoemulsification and intraocular lens implantation are common techniques for treating cataracts
A wide range of aspherical intraocular lenses are currently available for clinical application, the value added from the asphericity differs between them
Two questions emerge: (1) Can a random choice of different types of aspherical intraocular lenses used for implantation benefit all cataract patients, and (2) can customized implantation of corresponding aspherical intraocular lenses, which have a negative spherical aberration based on the pre-surgical corneal spherical aberration, improve visual quality
Summary
Cataract phacoemulsification and intraocular lens implantation are common techniques for treating cataracts. Ophthalmologists often seek to decrease the post-operative aberration of the whole eye and improve the quality of the patient’s vision. Aspherical intraocular lenses are widely used in intraocular lens implantation. Recent clinical studies have shown that aspherical intraocular lenses significantly improve post-operative vision in cataract patients compared with traditional intraocular lenses [1,2]. A wide range of aspherical intraocular lenses are currently available for clinical application, the value added from the asphericity differs between them. Two questions emerge: (1) Can a random choice of different types of aspherical intraocular lenses used for implantation benefit all cataract patients, and (2) can customized implantation of corresponding aspherical intraocular lenses, which have a negative spherical aberration based on the pre-surgical corneal spherical aberration, improve visual quality.
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