Objective optical quality in eyes with customized selection of aspheric intraocular lens implantation

Qing-Qing Tan,Xuan Liao,Jing Tian,Jia Lin,Chang-Jun Lan

doi:10.1186/s12886-019-1162-6

Abstract

BackgroundTo compare the postoperative optical quality in eyes with customized selection and random selection of aspheric intraocular lens (IOL) implantation.MethodsA prospective, nonrandomized study was implemented in adult cataract patients who underwent unilateral phacoemulsification with aspheric IOL implantation. Patients were allocated into two treatment groups: a customized group and a control group. In the customized group, the aspheric IOL selection was based on the corneal spherical aberration to enable the postoperative target ocular spherical aberration closest to zero; in the control group, the aspheric IOLs were chosen using a random strategy. Primary outcome measurements included the following objective optical quality assessments: higher-order aberrations obtained by a Hartmann-shack aberrometer at 4 mm and 6 mm pupil diameters; objective scatter index (OSI), modulation transfer function (MTF) cut-off, Strehl ratio (SR) and a simulated contrast visual acuity—optical quality analysis system value (OV) obtained by a double-pass system with a 4-mm aperture. Subjective visual acuity was measured as secondary outcome. All the patients were followed up for 3 months.ResultsEighty-four patients in the customized group and 78 patients in the control group were evaluated. There was no significant difference in postoperative visual acuity between the two groups (P > 0.05). Significantly less ocular higher-order aberrations were shown in the customized group (P < 0.05). No significant difference was shown in OSI, MTF cut-off, SR and OV between the two groups (P > 0.05).ConclusionsAlthough customized selection of aspheric IOL implantation showed less postoperative ocular aberrations, it performed similarly to random selection of aspheric IOL implantation in terms of postoperative visual acuity, simulated contrast visual acuity, intraocular scatter, modulation transfer function and Strehl ratio.Trial registrationRetrospectively registered on 07/06/2019. Registration number: ChiCTR1900024356.

Highlights

To compare the postoperative optical quality in eyes with customized selection and random selection of aspheric intraocular lens (IOL) implantation
Preoperative demographics, corneal astigmatism, corneal higher-order aberrations (HOAs) and IOL power showed no significant difference between the two groups (Table 1)
Akreos Adapt AO IOLs were selected for 1 patient, whose preoperative corneal spherical aberration (SA) was 0.085 μm; SN60WF IQ IOLs were selected for 26 patients, whose mean preoperative corneal SA was 0.21 ± 0.05 μm; Tecnis ZCB00 IOLs were selected for 57 patients, whose mean preoperative corneal SA was 0.33 ± 0.08 μm

Summary

Introduction

To compare the postoperative optical quality in eyes with customized selection and random selection of aspheric intraocular lens (IOL) implantation. To obtain optimal optical quality and visual performance for the pseudophakic eyes, reducing the higher-order aberrations (HOAs) is demanded. Wavefront aberrometers have been widely used in previous studies for assessing the optical quality by measuring the aberrations. They have a lack of information on quite higher-order aberrations and intraocular scatter [4]. Intraocular scatter is another important optical factor affecting visual performance. OQAS provides parameters including objective scatter index (OSI), modulation transfer function (MTF) cut-off, Strehl ratio (SR), and a simulated contrast visual acuity—optical quality analysis system values (OV) at contrasts of 100, 20 and 9%, which allow comprehensive assessment of the optical quality of the human eyes [6]. It has been successfully used to evaluate ocular optical quality in pseudophakic eyes [7, 8] and exhibited good repeatability [9, 10]

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