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.

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

Final enrollment 37 bilateral patients 18 SN60WF 19 Z9000

Healthy eyesPostop exam 3 months after surgery

Spherical Aberration (SA) Trace aberrometer/topographer (Tracey Technologies)

Non-dilated 4.5mm scan

VA Contrast

Methods

SN60WF Z9000

Design Single Piece Multi-Piece

Optic Zone 6.0 mm 6.0 mm

Central Optic Thickness 0.61 mm 0.50 mm

Chromophore Blue Light Filter None

Aspheric Surface

Posterior Anterior

Lens SA -0.21 μm -0.27 μm

Residual SA by Design 0.1 μm 0.0 μmResidual SA by Design 0.1 μm 0.0 μm

IOL Specifications

72% 68%

Lens had no apparent effect on amount of postoperative SA

n=74 eyes

0

5

10

15

20

25

30

SN60WF Z9000

Lens Model

Pe

rcen

t

<=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)

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 & one eye >

0.1 μm)

Results Analysis

<0.1μm >0.1μmMixed20/20

20/16

Sn

ellen

-0.10

-0.08

-0.06

-0.04

-0.02

0.00

Lo

gM

AR

(n=22) (n=9) (n=6)

Binocular BCVA with Three Postop SA Groups

20/20

Sn

ellen

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

Photopic Mesopic

Lo

gM

AR

<0.1 OU Mixed >0.1 OU(n=22) (n=9) (n=6)

12.5% Low Contrast Acuity with Three Postop SA Groups

0.000.200.400.600.801.001.201.401.601.802.002.20

1.5 3 6 12 18Cycles/Degree

Lo

g U

nit

s

<0.1 OU >0.1 OU Mixed(n=22) (n=9) (n=6)

Photopic Contrast Sensitivity with Three Postop SA Groups

0.000.200.400.600.801.001.201.401.601.802.002.20

1.5 3 6 12 18Cycles/Degree

Lo

g U

nit

s

<0.1 OU >0.1 OU Mixed

Mesopic Contrast Sensitivity with Three Postop SA Groups

0.000.200.400.600.801.001.201.401.601.802.002.20

1.5 3 6 12 18Cycles/Degree

Lo

g U

nit

s

<0.1 OU >0.1 OU Mixed

Mesopic with Glare Contrast Sensitivity with Three Postop SA Groups

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