Post-operative aberrations inHoya MICS and Tecnis IOL

Presenting author- Dr. Ravish Vaishnav Co-authors- Dr. Suhas Haldipurkar

- Dr. Vijay Shetty

Financial disclosure: The authors have no financial interest or have received any grants for this study

Application of Spherical Aberration+0.14 residual spherical aberration should be targeted

Preferable not to have negative spherical aberration

Zero spherical aberration good for quality of vision

Small amount of spherical aberration provides better depth perception

High amount of spherical aberration can cause distortion of image

Selection of IOL based on spherical aberration

SPHERICAL ABERRATION IOL USED

‹0.14 Spherical

0.14 to 0.20 Zero aspheric

0.21 to 0.35 Acrysof IQ (-0.20)

›0.35 Tecnis (-0.27)

ABC designof HOYA Aspheric

Spherical

FY-60AD

Aberration free IOL（ B&L aspheric ）

Alcon IQ (Designed to leave slight spherical aberration after IOL implantation)

0 1 2 317

18

19

20

21

Distance from the center (mm)

Powe

r (D

)[20.0 D lenses]

AMO Tecnis(Aiming zero-spherical

aberration after IOL implantation)

ABC design:1) Design that correct

corneal positive spherical aberration

2) Design that gives decentering tolerance

(negative)

This part possesses spherical aberration

(positive)

Higher order aberrations (HOA) are responsible for visual quality

Increased HOA affect contrast sensitivity and optical image quality

Aim:

Comparison of post-operative aberration profile of Hoya MICS IOL

and Acrysof IQ IOL

Objectives:To compare between the two groups 1. Aberration Profile 2. Defocus curve3. Contrast sensitivity 4. Dysphotopsia score

Study design

Comparative, Cross-sectional study

Sample size: 33 eyes in each group

Study Site: Laxmi Eye Institute, Panvel, India

Group 1 – Patients who had undergone cataract surgery with Hoya (Germany, FY-60AD) IOL implantation

Group 2 – Patients who had undergone cataract surgery with Tecnis (AMO Inc., ZCB00) IOL implantation

Inclusion CriteUneventful cataract surgery with

either Hoya MICS IOL or Acrysof

IQ IOL implanted

Post-op BCVA – 6/9, N6 and

better

Period of recruitment- Patients

who had undergone cataract

surgery from March 2015 to

February 2016

Exclusion Criteria:Any intra-operative

complication

Post-operative cystoid macular

oedema

Posterior capsular opacification

Any corneal or macular

pathology interfering with final

visual outcome

Inclusion Criteria Exclusion Criteria

MethodsParameter tested MethodVisual Acuity Snellen’s chart

Anterior segment evaluation Slit-lamp evaluation

Posterior segment evaluation Slit-lamp evaluation

Contrast sensitivity Pelli -Robson Chart

Higher order aberrations (HOA) Hoya I-trace

Defocus Curve As described (Philip Buckhurst et al. IOVS June 2012)

Dysphotopsia score Pilot tested, non validated questionnaire

Results HOYA MICS IOL TECNIS IOL

Total eyes 33 33Male 22 20Female 11 13Age Mean (SD) 58.9 (7.8) 60.9 (7.5)

Contrast Sensitivity

Hoya IOL Mean (SD)

Tecnis IOL Mean (SD)

P value

Photopic 1.38 (0.17) 1.42 (0.16) 0.28

Scotopic 1.22 (0.19) 1.22 (0.17) 0.99

Dysphotopsia questionnaire showed less dysphotopsia score with Tecnis IOL

Results- No statistical significant difference in undilated stateIn dilated state, statistical difference in internal & total HOA

and internal & total secondary astigmatism

-0.02

0

0.02

0.04

0.06

0.08

0.1 Undilated aberration profile

Tecnis

HOYA

Aberrations

mic

ron

-0.05

0

0.05

0.1

0.15

0.2

0.25

0.3 Dilated aberration profile

Tecnis

HOYA MICS

Aberrations

mic

ron

* * * ** Statistically significant

Defocus curve- Similar visual acuity in both groups at negative defocus values

-3.5-3-2.5-2-1.5-1-0.500.511.52

-0.3

-0.2

-0.1

-2.77555756156289E-16

0.0999999999999997

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

1.1

1.2

1.3

Defocus Curve Tecnis ZCB00 Vs HOYA MICS

Tecnis ZCB00

HOYA MICS

Defocus

VA l

ogM

AR

DiscussionIn this study, it was seen that Higher order aberrations were similar

between the two groups in undilated state

Aberrations after dilatation were significantly lower in Tecnis IOL group

We considered fixed pupil size. Therefore the aberration results are purely

representative of the design of the IOL [1]

In a studies by Roberto Belluci et al and Ahmad Assaf et al, Tecnis IOL

yielded better optical quality and lower aberrations [2]

Inspite of better design of HOYA-IOL, clinically we could not demonstrate

Hoya MICS IOL better than Tecnis IOL1. Sandoval HP, Fernandez de Castro LE, Vroman DT, Solomon KD. Comparison of visual outcomes, photopic contrast

sensitivity, wavefront analysis, and patient satisfaction following cataract extraction and IOL implantation: aspheric vs spherical acrylic lenses. In press, Eye 2008

2. Belluci R. Morselli S et al. Spherical aberration and coma with an aspherical and a spherical intraocular lens in normal age- matched eyesJ Cataract Refract Surg 2007; 33:203–209

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