Customized intraocular lenses enhance binocular depth‐of‐focus and optimize stereoscopic vision

Abstract

AbstractPurpose The purpose of this study was to evaluate mono and binocular near vision and depth‐of‐focus using two different aspheric monofocal intraocular lenses (IOL) profiles after micro‐incision cataract surgery.Methods Forty eyes (20 patients) were included. The reference group (28 eyes, 14 patients) received a ‐0.18 µm spherical aberration (SA) aspheric IOL in each eye (Acrismart 36A®, Carl Zeiss Meditec) whereas the aspheric‐customized group (12 eyes, 6 patients) received on the dominant eye an AcriSmart 36A® and on the other eye a zero‐aspheric IOL (Acrismart 46 LC®, Carl Zeiss Meditec). Inclusion criteria were a 0,15‐0,3 µm preoperative corneal SA and a monocular postoperative visual acuity (VA) ≥ 20/20. Reported visual outcomes were best corrected mono and binocular distance Snellen VA and uncorrected mono and binocular near VA. A binocular defocus curve was performed from +0.0 to ‐ 4.0 Diopters (D) by ‐0.25D step. A corneal and total higher‐order aberrations (KR1®, Topcon) evaluation was assessed. Stereoscopic vision was performed using TNO stereo test.Results Residual postoperative spherical equivalent and best corrected distance VA was not different between the two groups (respectively p = 0,11 and p = 0,82). However, the customized group had a better near and intermediate VA during the defocus curve, for example 20/80 versus 20/125 with ‐4.0D of defocus (p < 0.05). Customized group did not have penalized stereoscopic vision while comparing frequency of patients with TNO stereo test ≥ 120 seconds.Conclusion Differences in pseudophakic aspherical profiles of IOL in cataract surgery seemed to increase clinical depth‐of‐focus and near ability, without any disturbed distance vision or penalized stereoscopic outcomes.