Abstract
PurposeTo analyze internal spherical aberration in pseudophakic eyes that underwent aspheric intraocular lens (IOL) implantation, and to investigate the relationships between biometric data and the effectiveness of aspheric IOL implantation.MethodsThis retrospective study included 40 eyes of 40 patients who underwent implantation of an IOL having a negative spherical aberration of -0.20 μm (CT ASPHINA 509M; Carl Zeiss Meditec Inc., Germany). The IOLMaster (version 5.0; Carl Zeiss AG, Germany) was used for preoperative biometric measurements (axial length, anterior chamber depth, central corneal power) and the measurement of postoperative anterior chamber depth. The spherical aberrations were measured preoperatively and 3 months postoperatively using the iTrace (Tracey Technologies, Houston, TX, USA) at a pupil diameter of 5.0 mm. We investigated the relationships between preoperative biometric data and postoperative internal spherical aberration, and compared biometric measurements between 2 subgroups stratified according to internal spherical aberration (spherical aberration ≤ -0.06 μm vs. spherical aberration > -0.06 μm).ResultsThe mean postoperative internal spherical aberration was -0.087 ± 0.063 μm. Preoperative axial length and residual total spherical aberration showed statistically significant correlations with internal spherical aberration (p = 0.041, 0.002). Preoperative axial length, postoperative anterior chamber depth, IOL power, and residual spherical aberration showed significant differences between the 2 subgroups stratified according to internal spherical aberration (p = 0.020, 0.029, 0.048, 0.041 respectively).ConclusionThe corrective effect of an aspheric IOL is influenced by preoperative axial length and postoperative anterior chamber depth. Not only the amount of negative spherical aberration on the IOL surface but also the preoperative axial length should be considered to optimize spherical aberration after aspheric IOL implantation.
Highlights
The goal of modern cataract surgery is to improve visual acuity and to provide the best quality of vision possible
We investigated the relationships between preoperative biometric data and postoperative internal spherical aberration, and compared biometric measurements between 2 subgroups stratified according to internal spherical aberration
Preoperative axial length, postoperative anterior chamber depth, intraocular lens (IOL) power, and residual spherical aberration showed significant differences between the 2 subgroups stratified according to internal spherical aberration (p = 0.020, 0.029, 0.048, 0.041 respectively)
Summary
The goal of modern cataract surgery is to improve visual acuity and to provide the best quality of vision possible. The virgin cornea has a positive spherical aberration, [1] and corneal aberrations are at least partially compensated for by lenticular aberrations in young human eyes. [2] The aspheric intraocular lens (IOL) was developed to compensate for corneal aberrations and previous studies demonstrated the functional vision benefits of aspheric IOLs over conventional spherical IOLs. As the spherical aberration from the posterior corneal surface is subtle, internal spherical aberration is mainly affected by an IOL. The distance between the 2 lenses (the cornea and IOL) is called the effective lens position (ELP) or postoperative anterior chamber depth. [7] Based on the results of recent studies, we hypothesized that the effectiveness of spherical aberration correction in the corneal plane would vary according to preoperative biometry and postoperative anterior chamber depth in patients undergoing aspheric IOL insertion The ELP affects both the IOL spherical power for correction of the spherical equivalent and the cylinder power for reducing the postoperative refractive cylinder in toric IOL implantation. [6] A longer axial length and deeper ELP reduced the effect of near add power of a multifocal IOL. [7] Based on the results of recent studies, we hypothesized that the effectiveness of spherical aberration correction in the corneal plane would vary according to preoperative biometry and postoperative anterior chamber depth in patients undergoing aspheric IOL insertion
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