Abstract
Purpose: To compare visual acuity, aberrometry, and contrast sensitivity in eyes with spherical intraocular lens (IOL) and aspheric IOL implanted after uncomplicated phacoemulsification. Setting: Department of Ophthalmology, University Hospital, Hradec Kralove, Czech Republic. Methods: A prospective clinical study involving 90 patients (105 eyes) having cataract surgery, with implantation of spherical IOL AcrySof Natural (SN60AT) in 45 patients (50 eyes) with a mean age of 62.5 years, and aspheric IOL AcrySof IQ (SN60WF) in 45 patients (55 eyes) with a mean age of 64.5 years. A control group involved 22 eyes of similar age with clear lens crystallina. Postoperatively, visual acuity (ETDRS charts), aberrometry (ORK Wavefront Analyser, Schwind), and contrast sensitivity tests (CSV 1000, Contrast Sensitivity 8010 System) were evaluated. Statistical analyses were performed using Student t-test. Results: No statistical differences were found regarding visual acuity among eyes. A lower level of higher order aberrations was achieved in the aspheric group. In the contrast sensitivity test, no statistical differences between groups under photopic conditions were noted. In mesopic conditions better performance was observed in eyes with aspheric IOLs, mainly in low spatial frequencies (statistically significant). The control group (lens crystallina) was better in all frequencies. Conclusions: Cataract surgery outcomes cannot be measured by means of visual acuity alone. In this study, the aspheric IOLs AcrySof IQ (SN60WF) demonstrated better visual function, especially contrast sensitivity in low spatial frequences, when compared with spherical IOLs AcrySof Natural (SN60AT).
Highlights
Both ophthalmologists and patients currently approach cataract surgery as a “visual rescue operation” and as a refractive procedure
The purpose of this study was to compare visual acuity, Higher order aberrations (HOA), and contrast sensitivity of eyes implanted with aspheric intraocular lens (IOL) AcrySof IQ (SN60WF) with those of eyes implanted with spherical IOLs AcrySof Natural (SN60AT), and with a control group of eyes with clear crystalline lenses
The postoperative wavefront analysis including mean HOA root mean square (RMS) values, coma, higher order aberrations, and spherical aberration for both pseudophakic groups are demonstrated in figure 2
Summary
Both ophthalmologists and patients currently approach cataract surgery as a “visual rescue operation” and as a refractive procedure. Phacoemulsification and intraocular lens (IOL) implantation is considered the gold standard for cataract treatment. For “perfect” vision we need a “perfect” IOL. Even though conventional spherical IOL implantation provides higher contrast sensitivity than aphakia with spectacle correction, the contrast sensitivity in pseudophakic eyes is significantly lower than in normal phakic eyes [1]. Higher order aberrations (HOA) can reduce the quality of images in the optical system. With the new generation of aspheric IOLs, the anatomical and functional success of cataract surgery can be determined by improvement in visual acuity and its effects on the optical quality of the eye [2,3]
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