Postoperative Ocular Spherical Aberration Research Articles

Effect of larger corneal spherical aberration in improving the near visual acuity of eyes implanted with the TECNIS Symfony.

To explore the effect of corneal spherical aberration on the visual acuity and visual quality of eyes implanted with the TECNIS Symfony intraocular lens (IOL). A total of 43 patients with age-related cataract (60 eyes) undergoing phacoemulsification and TECNIS Symfony IOL implantation were enrolled in this study. The uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, and ocular spherical aberration were recorded 3 months after surgery. Preoperative and postoperative corneal spherical aberration were also measured using the iTrace device. Objective scattering index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) were measured by the Optical Quality Analyzing System. Catquest-9SF questionnaire were applied too. Spearman's correlation analysis was used to evaluate the relationship between spherical aberration and visual quality parameters. Patients were satisfied with their postoperatively visual quality. And the postoperative logMAR UDVA, UIVA, UNVA, and CDVA was 0.05 ± 0.07, 0.04 ± 0.06, 0.15 ± 0.07, and 0.03 ± 0.05, respectively. The mean preoperative corneal spherical aberration was 0.24 ± 0.10 μm, which is the only factor influencing postoperatively UNVA, and it was negatively correlated with UNVA and glare contrast sensitivity under 18 cpd (cycle/degree, cpd) spatial frequency (r = -0.403, -0.300, -0.360; all P < 0.05). Additionally, the greater the residual spherical aberration of the cornea, the better the near vision after operation. The mean postoperative ocular spherical aberration was -0.03 ± 0.07 μm, it was not correlated with visual acuity, contrast sensitivity, and visual quality (all P > 0.05). Preoperative positive spherical aberration can benefit near vision while decrease contrast sensitivities at high spatial frequencies when implanted with the TECNIS Symfony IOL.

First results with a new intraocular lens design for the individual correction of spherical aberration

To assess the feasibility of individual compensation of corneal spherical aberration with a custom intraocular lens (IOL). Department of Ophthalmology, Rudolf Virchow Klinikum Glauchau, Glauchau, Germany. Prospective case series. Cataract patients were randomized to receive an individual aberration-correcting IOL (Invidua-aA; Group A) or a standard aspheric aberration-free IOL of otherwise identical design (Aspira-aA; Group B). In Group A, the IOL was designed according to preoperative calculation of the corneal spherical aberration Z(4,0). The aim was to achieve an overall postoperative ocular spherical aberration close to zero. Four weeks and 3months postoperatively, the refraction, visual acuity (far, intermediate, and near distance), photopic and mesopic contrast sensitivities (with and without glare), defocus curve, corneal and ocular spherical aberration, and pupil size were measured. Group A, 57 eyes of 42 patients and Group B, 29 eyes of 27 patients. Preoperatively, there was no difference in corneal spherical aberration between groups (P>.05). Three months postoperatively, residual ocular spherical aberration Z(4,0) was significantly lower in Group A (P<.001). Photopic and mesopic contrast sensitivities (with and without glare) were significantly higher in Group A at most spatial frequencies. Monocular defocus curve and distance, intermediate, and near visual acuity outcomes did not differ significantly between groups. Implantation of a custom monofocal aspheric IOL effectively reduced overall ocular spherical aberration. Clinical outcomes indicate that IOLs with an individual spherical aberration correction improve functional vision, especially contrast sensitivity, compared with standard aberration-free IOLs.

Clinical Outcomes of Cataract Surgery with Correction of Corneal Spherical Aberration

Purpose: To evaluate preoperative and postoperative spherical aberrations after cataract surgery based on selecting spherical or aspheric intraocular lens (IOL) according to preoperative corneal aberration. Methods: The medical records of patients who underwent phacoemulsification and IOL implantation in the posterior chamber by a surgeon (H.J.C) were reviewed (68 patients, 97 eyes). IOL was selected based on preoperative corneal spherical aberration measured by corneal topography (ATLAS 9000, Carl Zeiss). The target postoperative total ocular spherical aberration was set to zero (0) and one of the following lenses was chosen: Acrysof SA60AT (n = 25), Acrysof IQ (n = 36) or Tecnis ZCB00 (n = 36). The Wavescan aberrometer and the corneal topography were obtained postoperatively. Absolute prediction errors of postoperative total ocular spherical aberration were analyzed. Results: Preoperative corneal spherical aberration was 0.241 μm; total postoperative ocular spherical aberration was 0.0509 μm (Acrysof SA60AT: 0.0954 μm, Tecnis ZCB00: 0.0374 μm, Acrysof IQ: 0.0335 μm). Postoperative corneal spherical aberration was 0.232 μm, which was not significantly different from the preoperative value (p = 0.199). Postoperative ocular spherical aberration was 0.051 μm; 0.095 μm (Acrysof SA60AT), 0.034 μm (Acrysof IQ), and 0.037 μm (ZCB00). The reducing amounts of spherical aberration were 0.185 μm (Acrysof IQ) and 0.311 μm (ZCB00). The overall absolute prediction error was 0.068 μm. The absolute prediction error of the Acrysof SA60AT group was 0.092 μm, Tecnis ZCB00 group was 0.067 μm and Acrysof IQ group was 0.054 μm. There was no significant difference among the 3 groups (p = 0.089). Conclusions: Aspheric IOLs can efficiently reduce total ocular spherical aberrations according to preoperative corneal spherical aberrations. J Korean Ophthalmol Soc 2014;55(6):809-816

Changes in Higher-Order Aberrations After Iris-Fixated Phakic Intraocular Lens Implantation

To evaluate surgically induced changes in corneal, internal, and ocular higher-order aberrations (HOAs) after phakic intraocular lens (PIOL) implantation and compare them between two PIOLs with different pupillary diameters. Twenty-three eyes with an Artisan PIOL (Ophtec BV, Groningen, The Netherlands) (Artisan group) and 30 eyes with an Artiflex PIOL (Ophtec BV) (Artiflex group) were retrospectively evaluated. The corneal, internal, and ocular HOAs and refractive data were recorded preoperatively and 6 months postoperatively. The root mean squares (RMSs) of the total HOAs from the third- to sixth-order Zernike coefficients were calculated. The RMSs of the third- and fourth-order coefficients represented coma-like aberrations (S3) and spherical-like aberrations (S4), respectively. The main outcome measures were the differences in the parameters among the groups with different pupillary diameters. The mean postoperative spherical equivalents decreased from -11.84 ± 4.90 to -0.16 ± 0.40 diopters and -9.78 ± 3.20 to -0.09 ± 0.26 diopters in the Artisan and Artiflex groups, respectively. With the 4- and 5-mm pupillary diameters, the postoperative internal and ocular spherical aberrations (Z4(0)) were significantly lower in the Artiflex group than in the Artisan group (4 mm, P = .002, .024; 5 mm, P = .004, .022, respectively). With the 6-mm pupillary diameter, there were no significant postoperative differences in any parameter measured between groups; both groups had positive spherical aberration values. The postoperative ocular spherical aberrations were positive after Artisan and Artiflex implantation. The postoperative ocular spherical aberration was greater in the Artisan group, possibly due to differences in the SAs of both PIOLs.

Predictability of ocular spherical aberration after cataract surgery determined using preoperative corneal spherical aberration

To evaluate the predictability of total postoperative spherical aberration after aspheric intraocular lens (IOL) implantation using preoperative corneal spherical aberration. Keio University Hospital, Tokyo, Japan. Corneal and ocular higher-order aberrations (HOAs) were analyzed preoperatively and postoperatively in eyes having cataract extraction with aspheric IOL implantation. The predicted postoperative total spherical aberration Z(4,0) was calculated by adding the preoperative corneal spherical aberration and the labeled spherical aberration of the IOL. The prediction error of the postoperative total spherical aberration was calculated by subtracting the predicted postoperative total spherical aberration from the postoperative total spherical aberration. Surgically induced corneal spherical aberration was calculated by subtracting the postoperative from the preoperative corneal spherical aberration. There were no statistically significant differences between preoperative and postoperative corneal spherical aberration, 3rd-order aberration, or HOAs. The prediction error of the postoperative total spherical aberration was within +/-0.05 microm in 9 (24.3%) of the 37 eyes evaluated and within +/-0.10 microm in 18 eyes (48.6%). Statistically significantly correlations were found between the surgically induced corneal spherical aberration and prediction error of postoperative total spherical aberration, the preoperative corneal spherical aberration and surgically induced corneal spherical aberration, and the preoperative corneal spherical aberration and prediction error of postoperative total spherical aberration. Predictability of postoperative ocular spherical aberration after cataract surgery with aspheric IOL implantation was insufficient because of the surgically induced corneal spherical aberration. Considering surgically induced corneal spherical aberration could improve the predictability of postoperative ocular spherical aberration.

Outcomes of Corneal Spherical Aberration-Guided Cataract Surgery Measured by the OPD-Scan

To determine based on preoperative corneal spherical aberration, the practicality of targeting zero total ocular postoperative spherical aberration when selecting an aspheric intraocular lens (IOL). Consecutive cataract patients were selected to receive an aspheric IOL based on corneal spherical aberration. A target of zero postoperative total spherical aberration Z(4,0) was calculated. One of three IOLs was chosen, based on the corneal spherical aberration Z(4,0) measurement at the 6-mm optical zone. The IOL was selected based on the summation of the corneal spherical aberration and the aspheric value of the prolate optic. The intention was an absolute value of zero total spherical aberration. Statistical analysis of the postoperative total ocular wavefront profile was performed to assess the accuracy of aspheric IOL selection. Forty eyes of 40 patients were available for postoperative assessment. The Tecnis Z9003 (Abbott Medical Optics) was implanted in 25 eyes with a preoperative corneal spherical aberration of +0.311±0.054 μm, the AcrySof IQ (Alcon Laboratories Inc) in 13 eyes (+0.188±0.034 μm), and the SofPort-Advanced Optic with Violet Shield (Bausch & Lomb) was implanted in 2 eyes (+0.0915 μm). Total postoperative ocular spherical aberration for the entire group measured +0.019±0.051 μm (Tecnis: +0.024±0.058 μm; AcrySof IQ: +0.010±0.035 μm; and SofPort AOV: +0.037 μm). Mean absolute predictive error, for the entire group, measured +0.025±0.020 μm. Skiascopy-derived total wavefront measurement of spherical aberration is a reproducible method of aspheric IOL selection and permits more precise control of total ocular spherical aberration.

Feasibility of spherical aberration correction with aspheric intraocular lenses in cataract surgery based on individual pupil diameter

To evaluate the feasibility of correcting spherical aberration with aspheric intraocular lenses (IOLs) in cataract surgery based on individual pupil diameter. Keio University Hospital, Tokyo, Japan. In this prospective study, eyes having cataract surgery were divided into 4 groups based on IOL type: aspheric SN (AcrySof SN60WF), aspheric ZA (Tecnis ZA9003), aspheric PY (Hoya PY-60 AD), and spherical (AcrySof Natural SN60AT). Postoperative higher-order aberrations (HOAs) of the cornea and whole eye and the pupil diameter under photopic and mesopic conditions were measured. The HOA was calculated using the individual pupil diameter. The correlation between corneal and ocular spherical aberrations and pupil diameter was evaluated. Each group comprised 30 eyes. Ocular spherical aberrations were significantly lower than corneal spherical aberrations under mesopic conditions in the aspheric SN group, the aspheric ZA group, and the aspheric PY group (P<.05); there was no significant difference between the aberrations in the spherical group. Linear regression showed significant correlations between postoperative corneal and ocular spherical aberrations (beta = 0.39, aspheric SN; beta = 0.38, aspheric ZA; beta = 0.58, aspheric PY; beta = 0.79, spherical). The differences in corneal and ocular spherical aberrations were significantly correlated with pupil diameter in the aspheric IOL groups but not in the spherical IOL group. The amount of spherical aberration correction by aspheric IOLs varied depending on IOL type and individual pupil diameter. The linear regression equation in this study may make it possible to customize postoperative ocular spherical aberration after cataract surgery.

Aspheric Intraocular Lens Selection Based on Corneal Wavefront

To determine the feasibility of selectively targeting zero total postoperative spherical aberration by selecting the best fit aspheric intraocular lens (IOL) based on preoperative topographically derived corneal spherical aberration. Candidates for cataract surgery were offered selection of aspheric IOLs based on corneal spherical aberration. The target postoperative total wavefront spherical aberration Z4,0 was set at zero. Corneal topographic spherical aberration Z4,0 was measured at the 6-mm optical zone, and one of three aspheric IOLs was chosen so the arithmetic sum of the corneal spherical aberration and pseudophakic spherical aberration came closest to zero. Postoperatively, total ocular wavefront was measured and statistical analysis performed to ascertain the accuracy of customized aspheric IOL selection. Thirty eyes of 18 patients were available for analysis. The SofPort Advanced Optics (Bausch & Lomb) lens was implanted in 1 eye, the AcrySof IQ (Alcon Laboratories Inc) in 11 eyes, and the Tecnis Z9000 or Z9002 (Advanced Medical Optics [AMO]) in 18 eyes. Total postoperative ocular spherical aberration for the entire population measured -0.013+/-0.072 microm (SofPort: +0.025 microm; AcrySof IQ: +0.010+/-0.053 microm; and Tecnis: -0.015+/-0.052 microm [P=.22]). For the entire population, mean absolute predictive error measured 0.058+/-0.056 microm (SofPort: 0.040 microm; AcrySof IQ: 0.052+/-0.040 microm; and Tecnis: 0.063+/-0.066 microm [P=.631). Customized selection of aspheric IOLs based on corneal wavefront is feasible and produces favorable results compared with studies of unselected patient populations implanted with aspheric IOLs.

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.