AcrySof SA60AT Intraocular Lens Research Articles

Intraindividual comparative analysis of capsule opacification after implantation of 2 single-piece hydrophobic acrylic intraocular lenses models: Three-year follow-up

To compare the 3-year postoperative anterior (ACO) and posterior (PCO) capsule opacification and the level of anterior capsule retraction after implantation of 2 single-piece hydrophobic acrylic intraocular lens (IOL) models. Hospital of St. John of God, Vienna, Austria. Comparative randomized controlled double-blind clinical trial. Eyes with bilateral cataract were evaluated. Each patient had an Acrysof SA60AT (interrupted optic edge) IOL implanted in 1 eye (Group A) and a Tecnis ZCB00 (continuous optic edge) IOL implanted in the fellow eye (Group B). One and 3 years postoperatively, PCO was evaluated using Evaluation of Posterior Capsule Opacification software and the ACO level and capsule-retraction level were evaluated and graded subjectively. The study evaluated 100 eyes of 50 patients ranging from 61 to 80 years. Postoperatively, there were no statistically significant differences in PCO between Group A and Group B at 1 year (0.06 ± 0.12 [SD] and 0.07 ± 0.13, respectively; P = 4.35) or 3 years (0.23 ± 0.36 and 0.22 ± 0.32, respectively; P = .66). In Group A and Group B, ACO was present in 18.0% of eyes and 2.7% of eyes, respectively, at 1 year (P = .03) and in 92.0% and 24.0%, respectively, at 3 years (P < .01). Capsule phimosis (18.0% at 1 year; 30.0% at 3 years) and glistenings (66.0% at 1 year; 86.0% at 3 years) were observed in Group A only. Both IOLs had similarly low PCO rates 3 years postoperatively, although more ACO and capsule retraction were observed in eyes with the interrupted optic edge IOL.

Clinical outcomes with a new microincisional diffractive multifocal IOL.

BackgroundTo evaluate the refractive outcomes and the optical performance as well as the quality of life in patients implanted with a new diffractive multifocal intraocular lens (IOL).MethodsProspective, clinical study including 41 cases of patients who underwent cataract surgery and were divided in two groups: group 1, including 20 eyes implanted with the multifocal IOL SeeLens MF (Hanita Lenses, Israel); group 2, 21 eyes implanted with the Acrysof SA60AT IOL. Visual acuity, defocus curve, intraocular aberrations, contrast sensitivity function and quality of life were assessed during a follow up period of 6 months.ResultsSignificant improvement was observed in the uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) in both groups (p < 0.02). The multifocal group showed better results in terms of uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) (p < 0.01). Comparison of both groups showed better visual acuities for the multifocal IOL group in defocus levels from -3.0 D to -1.50 D (p ≤ 0.01). At 6 months, there was a significant reduction of the internal higher order aberrations (p ≤ 0.04). A significant increase in scotopic contrast sensitivity was detected for 6 cycles/° spatial frequency during follow up (p = 0.04), but no significant changes were observed for the rest of spatial frequencies (p ≥ 0.06). Visual Functioning Index (VF-14) questionnaire showed that patients reported high levels of satisfaction when performing daily tasks.ConclusionsThe SeeLens MF IOL is able to successfully restore distance, near and intermediate visions after cataract surgery. It also provides functional intermediate vision with optimal intraocular optical quality.

In vitro examination of surface light scattering in hydrophobic acrylic intraocular lenses

To evaluate laboratory models using accelerated aging to assess surface light scattering in hydrophobic acrylic intraocular lenses (IOLs). Miyata Eye Hospital, Miyazaki, Japan. Experimental study. Acrysof SA60AT IOLs manufactured before optimization of the IOL production process (non-optimized IOLs) and Acrysof SN60WF IOLs that were manufactured after optimization of the production process (optimized IOLs) were examined. After the IOLs were accelerated aged corresponding to 0, 3, 5, 10, 15, and 20 years, surface light scattering was measured with a Scheimpflug camera. Formation of water aggregates below the IOL surface was observed with cryogenic focused ion-beam scanning electron microscopy. In the non-optimized IOLs, surface light scattering increased with aging (P<.001, R2=0.87). There was no significant increase in surface light scattering in the optimized IOLs. An increase in water aggregates with sizes of nanometer order was observed in the aged non-optimized IOLs. An in vitro model using accelerated aging was effective for examining the incidence of surface light scattering. The laboratory results showed suppression of surface light scattering in the IOL manufactured with the optimized process. No author has a financial or proprietary interest in any material or method mentioned.

Comparison of two optical biometers in intraocular lens power calculation

Aims:To compare the consistency and accuracy in ocular biometric measurements and intraocular lens (IOL) power calculations using the new optical low-coherence reflectometry and partial coherence interferometry.Subjects and Methods:The clinical data of 122 eyes of 72 cataract patients were analyzed retrospectively. All patients were measured with a new optical low-coherence reflectometry system, using the LENSTAR LS 900 (Haag Streit AG)/ALLEGRO BioGraph biometer (Wavelight., AG), and partial coherence interferometry (IOLMaster V.5.4 [Carl Zeiss., Meditec, AG]) before phacoemulsification and IOL implantation. Repeated measurements, as recommended by the manufacturers, were performed by the same examiner with both devices. Using the parameters of axial length (AL), corneal refractive power (K1 and K2), and anterior chamber depth (ACD), power calculations for AcrySof SA60AT IOL were compared between the two devices using five formulas. The target was emmetropia. Statistical analysis was performed using Statistical Package for the Social Sciences software (SPSS 13.0) with t-test as well as linear regression. A P value < 0.05 was considered to be statistically significant.Results:The mean age of 72 cataract patients was 64.6 years ± 13.4 [standard deviation]. Of the biometry parameters, K1, K2 and [K1 + K2]/2 values were significantly different between the two devices (mean difference, K1: −0.05 ± 0.21 D; K2: −0.12 ± 0.20 D; [K1 + K2]/2: −0.08 ± 0.14 D. P <0.05). There was no statistically significant difference in AL and ACD between the two devices. The correlations of AL, K1, K2, and ACD between the two devices were high. The mean differences in IOL power calculations using the five formulas were not statistically significant between the two devices.Conclusions:New optical low-coherence reflectometry provides measurements that correlate well to those of partial coherence interferometry, thus it is a precise device that can be used for the pre-operative examination of cataract patients.

Comparing the effect of two different intraocular lenses on optical aberrations in bilaterally operated eyes for cataract

To assess high order and spherical aberrations results of hydrophobic acrylic AMO Sensar AR40E and hydrophobic acrylic Alcon AcrySof SA60AT intraocular lenses after implantation in cases with bilateral cataract. Cases diagnosed as bilateral cataract were included in the study and preoperative aberration measurements were recorded by using Nidek OPD SCAN-ARK 1000. Groups were created by implanting AMO Sensar AR40E to one eye of the patients, while Alcon AcrySof SA60AT into the other in a prospective and randomized manner. Aberration measurements were recorded after one and two months of surgery. Overall, 40 eyes in 20 patients (11 women and 9 men) were included in the study. All patients underwent bilateral phacoemulsification surgery due to cataract. There were 20 eyes in both groups. Mean age was 62.4 (range: 31-82) years. There was no significant difference in aberrations recorded before surgery and one and two months after surgery in both groups. (p<0.05). There was no difference among spherical intraocular lenses used in this study.

Liquefaction in the Prevention of Posterior Capsule Opacification–Safety and Efficacy

Purpose: To evaluate the extent of posterior capsule opacification (PCO) following cataract surgery – torsional phacoemulsification with liquefaction method removal of the epithelial cells (right eye), and straight forward torsional phacoemulsification (left eye), with subsequent implantation of the AcrySof SA60AT intraocular lens. Methods: In this prospective clinical trial patients with bilateral cataract were observed. The Evaluation of Posterior Capsule Opacification (EPCO) 2000 software and the Open-Access Systematic Capsule Assessment (OSCA) system were used for PCO assessment at 3, 6, 12 and 24 months after surgery. Postoperative changes in endothelial cell count (ECC) and pachymetry were also evaluated. Results: The mean value for total EPCO index at 3, 6, 12 and 24 months postoperatively was respectively for the right eye 0.289 ± 0.223, 0.276 ± 0.176, 0.309 ± 0.185 and 0.418 ± 0.253, and for the left eye 0.302 ± 0.191, 0.301 ± 0.168, 0.355 ± 0.206 and 0.468 ± 0.309. The mean value for OSCA score (New Analysis) was for the right eye 0.612 ± 0.279, 0.603 ± 0.339, 0.559 ± 0.265 and 0.642 ± 0.401, and for the left eye 0.630 ± 0.398, 0.629 ± 0.366, 0.535 ± 0.331 and 0.574 ± 0.340. One patient underwent Nd-YAG laser capsulotomy one year after surgery (both eyes), and one patient two years postoperatively (right eye). There was minimal reduction in endothelial cell count and minimal changes in corneal thickness in both eyes. Conclusions: The AquaLase method is safe for ocular tissue. Two years after surgery, most cases of PCO were graded as minimal by both systems of analysis. Not withstanding the slightly better results in eyes with AquaLase polishing of the posterior capsule, this technique was not able to completely prevent a natural progression of PCO.

Myopic shift of foldable acrylic intraocular lenses after sulcus fixation

AimsThe aim of this retrospective study was to identify factors affecting myopic shift from predicted values of refraction after sulcus fixation of foldable acrylic intraocular lenses (IOLs).MethodsA total of 91...

Reduced effect of glare disability on driving performance in patients with blue light–filtering intraocular lenses

To compare the effects of glare on driving performance in patients who had implantation of a blue light-filtering acrylic intraocular lens (IOL) and those who had implantation of an acrylic IOL with no blue-light filter. Department of Applied Psychology, Arizona State University, Mesa, Arizona, USA. Cross-sectional study. Patients with a blue light-filtering AcrySof Natural SN60AT IOL (study group) and patients with an AcrySof SA60AT IOL with no blue-light filter (control group) who had good visual acuity and a valid driver's license performed left-turn maneuvers in a driving simulator in front of oncoming traffic. The safety margin (time to collision minus time taken to turn at intersection with oncoming traffic) was calculated. The measurements were repeated with a glare source simulating low-angle sun conditions (daytime driving). With glare, the safety margin was statistically significantly greater in the study group (n= 17) than in the control group (n = 17) (mean 2.534 seconds ± 0.488 [SD] and 2.116 ± 0.511 seconds, respectively) (P < .05). Comparing no-glare conditions and glare conditions, the study group had significantly lower glare susceptibility, fewer collisions with the oncoming car, and a lower impact on intersection approach speed than the control group. The IOL incorporating blue light-filtering technology significantly reduced glare disability and improved the driver's ability to safely execute a left turn with oncoming traffic in the presence of glare simulating low-angle sun conditions. The real-world benefit of this technology is presumably mediated by a stronger signal to detect approaching objects (motion-in-depth) as a result of a reduction in glare disability. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.

Visual axis opacification after cataract surgery and hydrophobic acrylic intraocular lens implantation in the first year of life

To report the incidence of visual axis opacification (VAO) requiring surgery after cataract extraction with hydrophobic acrylic intraocular lens (IOL) implantation during the first year of life. Storm Eye Institute, Charleston, South Carolina, USA; Iladevi Cataract and IOL Research Center, Ahmedabad, India. Cohort study. Medical records of patients younger than 1 year who had primary posterior capsulectomy, vitrectomy, and in-the-bag hydrophobic acrylic IOL implantation were reviewed. In bilateral cases, 1 eye was randomly chosen. The need for surgery for visually significant VAO was evaluated 12 months after cataract surgery. Seventy-two eyes were included. The mean age at cataract surgery was 6.0 months. Seventeen eyes (23.6%) required surgery for VAO a mean of 6.2 ± 2.9 months postoperatively. The odds for VAO surgery were 3.5 times greater in eyes of female children than in eyes of male children. For AcrySof MA60AC, SA60AT, SN60AT, or SN60WF IOLs, surgery for VAO was required in 25%, 23%, 23%, and 23% of eyes, respectively. The earliest time between cataract and secondary VAO surgery was relatively later (9.0 months) with the SN60WF IOL than with the MA60AC, SA60AT, or SN60AT IOL (4.4, 2.2, and 2.0 months, respectively). Nearly 25% of operated eyes of infants required a secondary surgical procedure for VAO; the rate was higher in eyes of female infants but did not differ between IOL models. The data indicate that surgery for VAO is required later in eyes with an SN60WF IOL than in eyes in which other AcrySof IOLs were used. No author has a financial or proprietary interest in any material or method mentioned.

Clinical evaluation of the transparency of hydrophobic acrylic intraocular lens optics

To clinically evaluate postoperative changes in the transparency of hydrophobic acrylic intraocular lenses (IOLs). Department of Ophthalmology, Dokkyo Medical University, Tochigi, Japan. Case-control study. Eyes having phacoemulsification were randomly assigned to have implantation of 1 of 3 hydrophobic acrylic IOL models. The IOLs were photographed at 0 degree and 90 degrees 1 week, 6 months, and 1 year after implantation using a Nidek EAS-1000 anterior chamber analyzer in slit mode. The images were used to determine the intensity of light scattering in the surface and middle regions of the IOL optic. The study comprised 65 eyes of 57 patients with a mean age of 72.5 years. The rate of increase in light-scattering intensity was similar in the middle and surface regions of the Tecnis ZA9003 aspheric IOL. The increase in light-scattering intensity in both regions of the AF-1 VA-60BB spherical IOL was greater than that in the aspheric IOL at all the measurement points. The intensity of light scattering was highest and tended to increase over time in both regions of the AcrySof SA60AT spherical IOL; the rate of increase in intensity was higher in the surface region than in the middle region, and the difference was significantly greater at 6 months and 1 year than at 1 week. Our results suggest that AcrySof SA60AT and AF-1 VA-60BB IOLs are likely to develop glistenings over time and that the former may develop whitening.

Comparison of the outcome of implantation of hydrophobic acrylic versus silicone intraocular lenses in pediatric cataract: prospective randomized study

Objective: To compare the postoperative performance of hydrophobic acrylic and silicone square-edge intraocular lenses in pediatric cataract. Design: Prospective randomized study. Participants: Forty-one eyes of 41 children (age 1 month to 8 years) with congenital or developmental cataract. Methods: Children were randomly divided into 2 groups. All participants underwent phacoaspiration, primary posterior capsulotomy, and anterior vitrectomy. Group A ( n = 21) eyes were implanted with acrylic hydrophobic AcrySof SA60AT intraocular lenses (IOLs), and those of Group B ( n = 20) were implanted with silicone Tecnis Z9000 IOLs. The children were evaluated for anterior chamber reaction, IOL position, posterior capsular opacifica-tion (PCO), intraocular pressure, best-corrected visual acuity (BCVA), corneal status, and refractive errors. Results: Postoperatively, 2 eyes in each group had significant anterior chamber reaction with fibrin membrane formation. IOLs were in the capsular bag in all but 1 eye in both groups. Seven eyes in the acrylic group and 6 eyes in the silicone group achieved visual acuity of 20/40 or better. None of the eyes showed glaucoma. BCVA at 1 year was similar in both groups. In the acrylic hydrophobic group, 14 eyes needed hypermetropic correction and 7 eyes were myopic, and in the silicone group 10 eyes had myopia and 10 eyes had hypermetropia at 1 year postoperatively. PCO at 1 yearfollow-up was more common in eyes implanted with acrylic hydrophobic IOLs (5 eyes) than silicone IOLs (2 eyes). Conclusions: Both square-edge hydrophobic acrylic and silicone IOLs were found to be compatible and safe for use in pediatric cataract surgery with similar visual axis clarity and postoperative outcome.

Islands of lens epithelial cells on the posterior capsule in pseudophakic eyes

To evaluate the natural history of focal collections (islands) of lens epithelial cells (LECs) on the posterior capsule after cataract surgery. Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom. Patients in previous studies with various intraocular lenses (IOLs) and at least a 2-year follow-up were identified. Postoperative digital retroillumination images of each eye taken at 1, 3, and 6 months and 1 and 2 years were assessed for the presence of LEC islands and their incidence, etiology, time of appearance, change with time, and relationship to IOL material. Islands of LECs were identified in 39 eyes with an AcrySof SA60AT IOL, 40 eyes with a Rayner Centerflex C570H IOL, and 27 eyes with a Hoya YA60BB IOL. In all groups, the islands tended to appear within 6 months with a decreasing incidence thereafter. Floating LECs that seeded on the posterior capsule (seeded LECs) or LECs left on the posterior capsule at surgery were seen in a small number of eyes. Most islands were derived from regression of a previous LEC membrane, and a majority continued to regress. Intraocular lens material had no influence on the natural history or morphology of the islands. Islands of LECs were common postoperatively. Equatorial LECs appeared to be the major cause of clinical posterior capsule opacification (PCO). Floating LECs in the aqueous that seeded on the posterior capsule or LECs left behind after surgery did not appear to contribute to clinical PCO. No author has a financial or proprietary interest in any material or method mentioned.

Pattern of posterior capsule opacification models 2 years postoperatively with 2 single-piece acrylic intraocular lenses

To compare posterior capsule opacification (PCO) in eyes with 1 of 2 models of 1-piece acrylic intraocular lenses (IOLs). Ambulatory surgery center. This paired-eye study evaluated patients who had implantation of a Tecnis AAB00 IOL with a continuous optic edge in 1 eye and an AcrySof SA60AT or SN60AT IOL with an interrupted optic edge in the fellow eye. Exclusion criteria were anterior capsule overlap onto the IOL optic of fewer than 360 degrees, neodymium:YAG laser capsulotomy, postoperative time fewer than 24 months or more than 30 months, pseudoexfoliation, glaucoma, history of iritis, and surgical complications that would affect the assessment of PCO. Posterior capsule opacification was assessed using the Evaluation of Posterior Capsular Opacification (EPCO) system on a scale of 0 (none) to 4 (severe opacity with a darkening effect). In 13 of 14 patients, the eye with the interrupted-edge IOL had a higher EPCO score than the eye with the continuous-edge IOL. The mean EPCO score was 0.39 and 0.08, respectively; the difference was statistically significant (P = .012). The PCO density was greater in eyes with the interrupted-edge IOL, with 35% having an EPCO score of 3 or 4; no eye with a continuous-edge IOL had a score that high. Eyes with an IOL with a continuous 360-degree square edge had significantly less PCO than eyes with an IOL with a square edge that was interrupted at the optic-haptic junction.

Ocular wavefront analysis and contrast sensitivity in eyes implanted with AcrySof IQ or AcrySof Natural intraocular lenses

This study aimed to compare ocular wavefront aberrations for pupil diameters of 4 mm and 6 mm, and contrast sensitivity, in eyes with AcrySof IQ and AcrySof Natural intraocular lenses (IOLs). Sixty eyes of 60 patients were enrolled in this prospective randomized study. After phacoemulsification the eyes received either AcrySof IQ SN60WF or AcrySof Natural SN60AT IOLs. One month after surgery, all patients underwent complete ophthalmological examination including corneal topography, wavefront analysis for pupil diameters of 4 mm and 6 mm, and contrast sensitivity measurements with the CSV 1000E instrument under photopic and mesopic conditions with and without glare. There was no statistically significant difference between groups in age, sex or other preoperative ocular characteristics (p > 0.05). Patients with AcrySof IQ IOLs had higher contrast sensitivity at 6 c.p.d. under photopic conditions, at 6 c.p.d. and 18 c.p.d. under mesopic conditions, and at 6 c.p.d., 12 c.p.d. and 18 c.p.d. under mesopic conditions with glare (p < 0.05). Corneal spherical aberration was 0.273 ± 0.074 μm in the AcrySof Natural group and 0.294 ± 0.086 μm in the AcrySof IQ group (p = 0489). Ocular spherical aberration was 0.362 ± 0.141 μm and 0.069 ± 0.043 μm (p < 0.001) for 6-mm diameter pupils and 0.143 ± 0.091 μm and 0.017 ± 0.016 μm (p < 0.001) for 4-mm diameter pupils, with AcrySof Natural and AcrySof IQ IOLs, respectively. There were no significant differences in other higher-order aberrations between the groups (p > 0.05). Aspherical AcrySof IQ IOLs significantly reduced spherical aberration for pupil diameters of both 4 mm and 6 mm and also improved contrast sensitivity more than spherical AcrySof Natural IOLs, especially in mesopic conditions.

Detection of pyrogens adsorbed to intraocular lenses: Evaluation of limulus amoebocyte lysate and in vitro pyrogen tests

To determine the ability of the limulus amoebocyte lysate (LAL) assay and the in vitro pyrogen test (IPT) to detect pyrogens adsorbed to intraocular lenses (IOLs). Berlin Eye Research Institute, Berlin, Germany. Fifteen of each of the following IOLs were used: MicroSil MS 612 ASP, AcrySof SA60AT, Superflex, Sensar, XACT, and LS-106 IOLs. The challenge organism suspensions were 10(3) CFU/mL and 10(4) CFU/mL Escherichia coli, 10(3) CFU/mL and 10(4) CFU/mL Pseudomonas putida, and 10(5) CFU/mL and 10(6) CFU/mL Staphylococcus epidermidis. Two IOLs of each model were incubated at room temperature for at least 2 days in 0.6 mL of 1 of the suspensions. They were then gamma sterilized. The extract of 1 IOL was tested with the LAL assay; the other IOL was tested with the IPT. The LAL was negative for all incubated IOLs. The IPT was positive for all IOLs incubated in E coli and P putida suspensions, with the MicroSil MS 612 ASP, AcrySof SA60AT, XACT, and LS-106 IOLs showing a severe reaction. The Superflex and Sensar IOLs had a slight to moderate response for lower bacterial concentrations and a moderate to severe response for higher concentrations. For S epidermidis, all IOLs showed a slight IPT response except XACT IOLs, which showed a nonpyrogenic response. Results indicate that the LAL test may fail to detect pyrogens adsorbed to IOLs and the IPT reliably detects pyrogens with a dose-dependent response. This has relevance in the investigation of toxic anterior segment syndrome outbreaks.

Three-Year Follow-up of Posterior Capsule Opacification After AquaLase and NeoSoniX Phacoemulsification

To prospectively compare the degree of posterior capsule opacification (PCO) after AquaLase and NeoSoniX phacoemulsification methods during the 3-year follow-up period. Prospective, randomized clinical trial. Setting at the Department of Ophthalmology, University Hospital in Hradec Králové. Patients with bilateral cataract were included. AquaLase was used in the right eye and NeoSoniX in the left eye of each patient. The AcrySof SA60AT intraocular lens (Alcon Laboratories, Fort Worth, Texas, USA) was implanted in all eyes. The Evaluation of Posterior Capsule Opacification (EPCO) 2000 software (Developed by Tetz MR and associates, Berlin, Germany) and the Open-Access Systematic Capsule Assessment (OSCA) system (Devised by Aslam TM, Edinburgh, United Kingdom) were used for PCO assessment 1, 2, and 3 years after cataract surgery. Fifty patients were analyzed 1 year, 47 patients 2 years, and 46 patients 3 years after cataract surgery. Mean EPCO 2000 values were for the AquaLase group 0.324 +/- 0.305 and for the NeoSoniX group 0.298 +/- 0.341 (P = .53) 1 year after surgery, for the AquaLase group 0.429 +/- 0.322 and for the NeoSoniX group 0.478 +/- 0.337 (P = .30) 2 years after surgery, and for the AquaLase group 0.582 +/- 0.506 and for the NeoSoniX group 0.594 +/- 0.515 (P = .87) 3 years after surgery. The OSCA results were for the AquaLase group 0.7097 +/- 0.3778 and for the NeoSoniX group 0.8584 +/- 0.4323 (P = .046) 1 year after surgery, for the AquaLase group 0.7515 +/- 0.4555 and for the NeoSoniX group 0.8103 +/- 0.4498 (P = .44) 2 years after surgery, and for the AquaLase group 0.9667 +/- 0.736 and for the NeoSoniX group 0.9540 +/- 0.5250 (P = .91) 3 years after surgery. Neodymium-yttrium-aluminun-garnet capsulotomy rate for AquaLase vs NeoSoniX was 0:1 eyes 1 year, 1:3 eyes 2 years, and 1:4 eyes 3 years after surgery. No significant difference between those 2 groups was established, except the OSCA outcomes 1 year postoperatively. There was only minimal PCO difference between these 2 approaches, AquaLase and NeoSoniX. Neither AquaLase nor NeoSoniX technique was able to prevent a natural progression of PCO.

Improvements in vision-related quality of life with AcrySof IQ SN60WF aspherical intraocular lenses

To compare vision-related quality of life and higher-order aberrations (HOAs) with an aspherical intraocular lens (IOL) (AcrySof IQ SN60WF) and a conventional spherical IOL (AcrySof SA60AT) (both Alcon) after phacoemulsification. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China. Sixty-five patients were prospectively randomized to receive an Alcon AcrySof IQ SN60WF IOL (30 eyes) or an AcrySof SA60AT IOL (35 eyes). All patients had a complete ophthalmologic examination including uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), and wavefront analysis preoperatively and 3 months postoperatively. Patients also completed the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) to evaluate vision-related quality of life. The mean postoperative BSCVA (logMAR) was 0.09 +/- 0.07 (SD) in the aspherical IOL group and 0.12 +/- 0.08 in the spherical IOL group; the difference was not statistically significant. Spherical aberrations were statistically significantly lower in the aspherical IOL group (mean 0.12 +/- 0.23 microm) than in the spherical IOL group (mean 0.33 +/- 0.20 microm) (P = .001). Both IOL types improved most aspects of patients' vision-related quality of life. The aspherical IOL group had clinically significant improvement on more NEI VFQ-25 subscales, although the difference between groups in vision-related quality of life was not statistically significant. Eyes with the aspherical AcrySof IQ SN60WF IOL had reduced HOAs and spherical aberrations compared with eyes with the spherical AcrySof SA60AT IOL; however, there were no statistically significant differences in visual acuity or vision-related quality of life between groups.

Intraocular straylight after implantation of the multifocal AcrySof ReSTOR SA60D3 diffractive intraocular lens

To measure intraocular straylight (as a measure of glare) after cataract surgery and implantation of an AcrySof ReSTOR SA60D3 multifocal or AcrySof SA60AT monofocal intraocular lens (IOL) (both Alcon Laboratories). University Hospital Maastricht, Maastricht; Isala Clinics, Zwolle; Netherlands Institute for Neurosciences, Amsterdam, The Netherlands. In a prospective open observational case series, a newly developed straylight meter was used to objectively measure straylight 6 months postoperatively in 66 eyes with a diffractive AcrySof ReSTOR SA60D3 IOL (multifocal group) and 40 eyes with a monofocal AcrySof SA60AT IOL (monofocal group). A comparison of straylight levels in an age-matched population without cataract (control group) was performed. The straylight level was 1.20 log units +/- 0.16 (SD) in the multifocal group and 1.10 +/- 0.19 log units in the monofocal group. When the difference in mean level of straylight was adjusted for age, mean straylight levels were 0.078 log units lower in the monofocal group than in the multifocal group (P = .026). Straylight levels in both pseudophakic groups were lower than in the control group without cataract (P< .0001). Levels of intraocular straylight log(s) were significantly lower for both types of IOL than in age-matched subjects from the normal population. The mean level of intraocular straylight 6 months postoperatively was higher in patients with an AcrySof ReSTOR SA60D3 IOL than in patients with a monofocal AcrySof SA60AT IOL. Implantation of the former IOL would therefore result in a smaller gain in contrast sensitivity and a smaller reduction in glare and halos than implantation of the latter IOL.

Comparison of the AcrySof IQ Aspheric Blue Light Filter and the AcrySof SA60AT Intraocular Lenses

The development of aspheric intraocular lenses (IOL) designed to compensate for the positive spherical aberration of the cornea has been shown to improve the image quality of pseudophakic eyes. This prospective clinical study compared an aspheric IOL with a blue light filter (AcrySof IQ) with its spherical platform--the SA60AT IOL with conventional optic. After uneventful phacoemulsification, 42 and 20 eyes were implanted with the AcrySof IQ aspheric lens and the SA60AT, respectively. Six weeks after surgery, higher order aberrations, visual acuity, contrast sensitivity, depth of focus, pupil size, and corneal asphericity were assessed. Visual acuity was good with both IOLs. A significant difference was found regarding spherical aberration. Mean values of spherical aberration, calculated for a 5-mm pupil were 0.20 +/- 0.06 microm with the SA60AT and 0.04 +/- 0.05 microm with the AcrySof IQ lens. Contrast sensitivity was significantly superior in the AcrySof IQ group in 7 of 15 measurement conditions. Asphericity of the cornea proved to be correlated with postoperative ocular spherical aberration. The aspheric optic design of the AcrySof IQ results in significant reduction of postoperative ocular spherical aberration and improved contrast vision. Measuring the corneal asphericity allows estimation of postoperative ocular spherical aberration.

Wavefront and Visual Function Analysis After Aspherical and Spherical Intraocular Lenses Implantation

Purpose: To compare postoperative wavefront aberration and visual functions between aspherical Tecnis Z9003, a new acrylic aspheric intraocular lens (IOL), and spherical AcrySof SA60AT IOL. Methods: Fifty patients (56 eyes) who underwent cataract extraction and were implanted with spherical or aspherical IOLs were randomly evaluated by wavefront analysis, including an examination of spherical aberration and higher-order aberrations using two different types of aberrometers (ray tracing and automatic retinoscope), manifested refraction, a contrast sensitivity test, and modulation transfer function (MTF), three months after surgery. Result: There were no statistically significant differences of spherical equivalent and best-corrected visual acuity between the two different IOL groups. However, the aspherical IOL group showed less spherical aberration and better contrast sensitivity and MTF than the spherical IOL group. Conclusions: Tecnis Z9003 could compensate for positive spherical aberrations of the cornea and improve contrast sensitivity and MTF, thereby improving visual function. J Korean Ophthalmol Soc 49(8):1248-1255, 2008