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Spherical Aberration Post Bilateral Implantation of Two Prevalent Aspheric IOLs DR. ROBERT A. KAUFER, MD MARTINEZ, BUENOS AIRES ARGENTINA robert@kaufer.com This research funded by Alcon Laboratories.
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To determine the aspheric lens with the best clinical outcomes in a real-world setting where preoperative wavefront analysis for aspheric lens customization is not the standard of care. Purpose
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Final enrollment 37 bilateral patients 18 SN60WF 19 Z9000 Healthy eyes Postop exam 3 months after surgery Spherical Aberration (SA) Trace aberrometer/topographer (Tracey Technologies) Non-dilated 4.5mm scan VA Contrast Methods
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SN60WFZ9000 DesignSingle PieceMulti-Piece Optic Zone6.0 mm Central Optic Thickness 0.61 mm0.50 mm ChromophoreBlue Light FilterNone Aspheric Surface Posterior Anterior Lens SA-0.21 μm-0.27 μm Residual SA by Design 0.1 μm0.0 μm Residual SA by Design 0.1 μm0.0 μm IOL Specifications
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72% 68% Lens had no apparent effect on amount of postoperative SA n=74 eyes 0 5 10 15 20 25 30 SN60WFZ9000 Lens Model Percent <=0.025 0.025-0.050 0.05-0.075 0.075-0.1 0.1-0.125 0.125-0.150 0.15-0.175 0.175-0.2 >0.2 Percent Distribution of Postop Spherical Aberration (μm)
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If lens model had no effect on postop SA distribution… Does lens model have an effect on performance at a specified SA range? Patients broken into 3 groups <0.1μm postop SA OU >0.1μm postop SA OU Mixed (one eye 0.1 μm) Results Analysis
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<0.1μm>0.1μmMixed 20/20 20/16 Snellen -0.10 -0.08 -0.06 -0.04 -0.02 0.00 LogMAR (n=22)(n=9)(n=6) Binocular BCVA with Three Postop SA Groups
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20/20 Snellen 20/25 20/30 20/40 20/50 20/63 20/80 0.00 0.10 0.20 0.30 0.40 0.50 0.60 PhotopicMesopic LogMAR <0.1 OUMixed>0.1 OU (n=22)(n=9)(n=6) 12.5% Low Contrast Acuity with Three Postop SA Groups
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0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 2.20 1.5361218 Cycles/Degree Log Units <0.1 OU>0.1 OUMixed (n=22)(n=9)(n=6) Photopic Contrast Sensitivity with Three Postop SA Groups
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0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 2.20 1.5361218 Cycles/Degree Log Units <0.1 OU>0.1 OUMixed Mesopic Contrast Sensitivity with Three Postop SA Groups
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0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 2.20 1.5361218 Cycles/Degree Log Units <0.1 OU>0.1 OUMixed Mesopic with Glare Contrast Sensitivity with Three Postop SA Groups
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A slight positive postoperative SA (>0.1 μm) appears to enhance visual acuity. Larger populations are likely required to evaluate the modest impact of SA on contrast. Postoperative SA alone was not a predictor of contrast sensitivity. Postoperative analysis should include coma and total HOA to account for all residual aberrations of the eye. Conclusions
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