1. Vinohrady Teaching Hospital, Prague, Czech Republic Vinohrady Teaching Hospital, Prague, Czech Republic M. Vokrojova MD, M. Vokrojova MD, D. Sivekova MD, L. Wagnerova MD D. Sivekova MD, L. Wagnerova MD Prof. P. Kuchynka MD, PhD Prof. P. Kuchynka MD, PhD The authors have no financial interest in the presentation material Comparison of the Aspherical Tecnis Z9002 and the Spherical Clariflex Silicone IOLs

2. PURPOSE, OBJECTIVE To evaluate quality of visual function after cataract surgery with implantation of spherical silicon intraocular lens to the one eye and aspherical silicon intraocular lens to the second eye of the same patient, and compare the results between these two different types of lenses. To evaluate quality of visual function after cataract surgery with implantation of spherical silicon intraocular lens to the one eye and aspherical silicon intraocular lens to the second eye of the same patient, and compare the results between these two different types of lenses. We conducted a prospective study, We conducted a prospective study, to compare patients visual functions. to compare patients visual functions.

3. Endpoints included postoperative BCVA postoperative BCVA UNCVA UNCVA efficacy efficacy wavefront - analysis wavefront - analysis contrast sensitivity under photopic condition contrast sensitivity under photopic condition subjective satisfaction of the patients subjective satisfaction of the patients

4. MATERIALS, METHODS The group of the patients: The group of the patients: 40 eyes of 20 patients were randomly assigned and examined by masked examiner 40 eyes of 20 patients were randomly assigned and examined by masked examiner The mean age of the patients was 72,5 (59 - 84) years. The mean age of the patients was 72,5 (59 - 84) years. 11 (55%) women, 9 (45%) men. 11 (55%) women, 9 (45%) men. Cataract condition was presented in all cases. Cataract condition was presented in all cases. Mean preoperative BCVA: 0,4 (0,32 - 0,8) Mean preoperative BCVA: 0,4 (0,32 - 0,8) All surgeries were performed by an experienced surgeon using phacoemulsification with the Infinity Vision system (Alcon), topical anesthesia and standard surgical procedure. All surgeries were performed by an experienced surgeon using phacoemulsification with the Infinity Vision system (Alcon), topical anesthesia and standard surgical procedure.

5. MATERIALS, METHODS  TECNIS® IOL was developed with help of wavefront technology.  3-pieces, foldable, UV-blocking filter  Biconvex optic diameter 6,0 mm  Third generation silicone material: polydimethyl - diphenylsiloxane  OptiEdge™ design  A - constant: 118,4 - „Aspherical“ anterior prolate surface - Refractive index of 1.46 - Negative spherical aberration -0,27 μm  3-pieces, foldable, UV - blocking filter  Biconvex optic diameter 6,0 mm  Third generation silicone material: polydimethyl - diphenylsiloxane  OptiEdge™ design  A - constant: 118,0 - Refractive index of 1.46 Tecnis Z9002 Clariflex

6. MATERIALS, METHODS All patients were evaluated by a wavefront analyzer (Wavescan), contrast sensitivity (CSV-1000). All patients were evaluated by a wavefront analyzer (Wavescan), contrast sensitivity (CSV-1000). - wavefront - analysis was performed monocularly with Wavescan (VISX) 3 months postoperatively. - wavefront - analysis was performed monocularly with Wavescan (VISX) 3 months postoperatively. - contrast sensitivity was measured monocularly with the best distance correction with CSV – 1000 instrument 3 months postoperatively. - contrast sensitivity was measured monocularly with the best distance correction with CSV – 1000 instrument 3 months postoperatively.

7. RESULTS Aspherical IOL group (n=20) Non-aspherical IOL group (n=20) UNCVA: 0,94 (0,63 - 1,0) BCVA: 0,98 (0,8 - 1,0) Efficacy index: post.UCVA/preop.BCVA 0,98/0,4 2,45 UNCVA: 0,93 (0,63 - 1,0) BCVA: 0,97 (0,8 - 1,0) Efficacy index: post.UCVA/preop.BCVA 0,97/0,4 2,425

8. Aspherical IOL Non aspherical IOL HOA Spherical aberration HOASpherical aberration 0,15598 SD ± 0,049 -0,02339 SD ± 0,054 0,196158 SD ± 0,089 0,17598 SD ±0,062 Aspherical IOL Non-aspherical IOL RESULTS

9. RESULTS Results of the wavefront Results of the wavefront analysis show that aspheric intraocular lens significantly reduces the occurrence of spherical aberration (p< 0,01) Examination was performed min.1 month postop. Min. pupil size was 5,5 mm

10. RESULTS Results of the examination of contrast sensitivity show that aspheric intraocular lens are significantly better than spherical lenses (p< 0,05). Results of the examination of contrast sensitivity show that aspheric intraocular lens are significantly better than spherical lenses (p< 0,05). Aspherical IOL Non-asperical IOL 85 cd/m2 85 cd/m2

11. Discussion The theoretical preclinical calculations studies suggest that spherical aberration of the eye after cataract surgery using the anterior prolate surface lenses can be modified. The theoretical preclinical calculations studies suggest that spherical aberration of the eye after cataract surgery using the anterior prolate surface lenses can be modified. The anterior prolate surface of the Tecnis Z9002 results in a negative spherical aberration of – 0,27 μm for 6,0 mm pupil to compensate positive spherical aberration of the cornea. The anterior prolate surface of the Tecnis Z9002 results in a negative spherical aberration of – 0,27 μm for 6,0 mm pupil to compensate positive spherical aberration of the cornea. The recent studies found that these modified lenses can improve contrast sensitivity under mesopic and photopic conditions. The recent studies found that these modified lenses can improve contrast sensitivity under mesopic and photopic conditions.References: 1. Packer M. Fine IH. Hoffman RS. Prospective randomized trial of an anterior surface modified prolate intraocular lens. J Refract Surg 2002;18:692-696 2. Packer M. Fine IH. Hoffman RS. Improved functional vision with modified prolate intraocular lens. J Cataract Refract Surg 2004; 30: 986-992 3. Beiko GHH. Personalized correction of spherical aberration in catarct surgery. 2007; 33: 1455-1460.

12. CONCLUSSION Our results confirm that use of aspherical lenses can reduce occurrence of spherical aberration and can improve the visual performance of patients. Our results confirm that use of aspherical lenses can reduce occurrence of spherical aberration and can improve the visual performance of patients. The benefit of this lens can be appreciated only from patients with increased visual demands like car drivers, like our results suggest. The benefit of this lens can be appreciated only from patients with increased visual demands like car drivers, like our results suggest.