Abstract
To analyze using optical simulations if the proper use of a segmented intraocular lens (IOL) can improve the visual outcomes compared to the implantation of a spherical monofocal IOL. The wavefront profile of the Mplus (Oculentis) and a monofocal IOLs with the phase transformation introduced by each IOL were calculated using a Hartmann-Shack wavefront sensor. In addition, the wavefront profile of schematic eye models of various keratoconus conditions was obtained and was propagated to the IOLs. The optical performance of such combination was obtained after combining ray tracing and Fourier optics. A pre-clinical validation was also evaluated incorporating clinical data from three different keratoconus eyes of three patients. The implantation of the Mplus IOL can compensate or reduce the overall coma of the eye with keratoconus improving the quality of vision compared with a spherical monofocal IOL due to lower displacements of the retinal image or tilting in keratoconus. All theoretical simulations were confirmed afterwards by mean of a preclinical validation. The use of a standard toric segmented IOL with a proper orientation and selection of the addition can improve the optical quality of the keratoconus eye compared to the use of a monofocal spherical IOL.
Highlights
IntroductionIn a more recent study Nilagiri et al indicated that optical performance of keratoconic eyes are significantly better with Rigid Gas Permeable Contact Lenses than with spectacles because the HOAs are lower[6]
The vertical coma generated by the Mplus intraocular lenses (IOLs) was + 0.169 μm and the horizontal − 0.074 μm for a 6-mm pupil, and they compensated the vertical and horizontal coma components that were present in the mild KC case (− 0.170 and + 0.074 μm respectively)
This amount of coma produced by the Mplus IOL was not enough to compensate the entire coma aberration that was present in the rest of KC cases evaluated
Summary
In a more recent study Nilagiri et al indicated that optical performance of keratoconic eyes are significantly better with Rigid Gas Permeable Contact Lenses than with spectacles because the HOAs are lower[6]. Considering that negative coma is the dominant high order aberration in keratoconus eyes and that this coma could be compensated generating positive coma, our aim was to analyze using optical simulations if the proper use of a standard segmented IOL can diminish the level of primary coma in keratoconus, promoting an improvement of the visual outcomes compared to the implantation of a spherical monofocal IOL. For such purpose, data and procedures previously reported in two already published papers were used. They stablished that this option may become a promising option for the correction of advanced aberrations in eyes with non-progressive keratoconic corneal tomography p attern[17]
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