非球面人工晶状体在白内障超声乳化术的临床应用

目的:超声乳化术后植入非球面人工晶状体(Tecnis Z9001)或球面人工晶状体(Acrysof Nature),临床疗效的比较.方法:年龄相关性白内障患者59例60眼,随机分为2组,每组30眼.在超声乳化术后,一组植入非球面人工晶状体(Tecnis Z9001),另一组植入球面人工晶状体(Acrysof Nature).在术后1/4,1及3 mo检查术眼最佳矫正视力(BCVA);在术后1及3 mo检查明视及暗视对比敏感度、眼波前像差等.结果:术后1/4,1及3 mo,两组BCVA均无显著性差异(P＞0.05).在术后1及3 mo,Tecnis组在明视1.5 cpd,3.0 cpd,6.0 cpd,12 cpd,18 cpd及暗视1.5 cpd,3.0 cpd,6.0 cpd,12 cpd,18 cpd的对比敏感度均明显优于Acrysof组,差别有统计学意义(P＜0.05).在术后1及3 mo,两组四阶球差(SA)及高阶像差(HOA)比较,Tecnis组均低于Acrysof组,两组差别有统计学意义(P＜0.05).结论:非球面人工晶状体(Tecnis Z9001)与球面人工晶状体(Acrysof Nature)均可明显提高患者术后视力,但非球面人工晶状体(Tecnis Z9001)可以减少术眼的高阶像差尤其是球差,提高某些频率的对比敏感度,提高视觉质量.     

Tecnis MF和ReZoom两种人工晶状体的临床对比研究

目的:比较应用Tecnis MF和ReZoom两种多焦点人工晶状体植入术后1mo患者视力及对比敏感度(contrast sensitivity,CS)变化情况。方法:采用同期随机对照研究,选取年龄相关性白内障患者58例(74眼),随机分为两组,ReZoom IOL组(28例,28眼)植入人工晶状体ReZoom,Tecnis MFIOL组(30例,46眼)植入Tecnis MFIOL。术后第1mo检查矫正视力、无眩光及眩光环境下对比敏感度。结果:Tecnis MF近视力优于ReZoom(P<0.05),ReZoom中视力优于Tecnis MF(P<0.05),两者远视力无显著差异。Tecnis MF在空间频率为18c/d和24c/d时对比敏感度优于ReZoom(P<0.05)。两者眩光对比敏感度在各空间频率均无显著差异。结论:Tecnis MF及ReZoom在屈光晶状体手术中,对患者预后的影响各异,因此个性化使用Tecnis MF和ReZoom IOL为影响患者预后的关键环节。     

非球面散光矫正型多焦点人工晶状体植入术对白内障患者视力和对比敏感度的影响

目的：观察非球面散光矫正型多焦点人工晶状体植入术对白内障患者视力和对比敏感度的影响。
　　方法：将我院2014-05/2015-05期间行超声乳化人工晶状体植入术的合并有角膜规则散光的白内障患者58例72眼,随机分为两组：观察组植入散光矫正型多焦点人工晶状体29例36眼;对照组植入散光型单焦点人工晶状体29例36眼。术后随访1、6mo,观察术后患者的裸眼远视力(UCDVA)、裸眼近视力(UCNVA)、最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)、残余散光、暗光下对比敏感度。
　　结果：两组术后1、6mo UCDVA、BCNVA、BCDVA 以及残余散光的比较差异无统计学意义(P>0.05);观察组术后1、6mo 的 UCNVA 优于对照组(P<0.05);术后6mo 两组对比敏感度在高空间频率比较上差异有统计学意义(P<0.05)。
　　结论：非球面散光矫正型多焦点人工晶状体植入术治疗合并有角膜规则散光的白内障患者疗效确切,与散光型单焦点人工晶状体植入术比较均可改善患眼视力,且采用非球面散光矫正型多焦点人工晶状体植入术治疗后可获得更好的裸眼近视力和对比敏感度。     

微切口人工晶状体植入术后早期波前像差及对比敏感度比较

目的:探讨微切口Acri.smart 36A人工晶状体(德国Acri.tec公司)的非球面设计对人工晶状体眼的视觉质量和光学质量的影响.方法:老年性白内障患者26名28眼随机1眼植入Acri.smart 36A或者Acri.smart 46S,如另外1眼需要白内障手术,选择相同型号的人工晶状体.人工晶状体Acri.smart36A组13眼,46S组Acri.smart 15眼,患者年龄,术前散光度数,所植入人工晶状体的度数,昏暗环境下瞳孔直径,药物散瞳后瞳孔直径大小均无统计学差异.两种微切口人工晶状体都通过1.4mm微切口植入.术后1mo测散瞳下波前像差(日本Nidek OPD-Scan波前像差仪);散瞳前后分别矫正到最佳视力后用OPTEC6500(美国Stereo optic公司)对比敏感度仪测得对比敏感度.结果:正常瞳孔下,两组人工晶状体不同空间频率(1.5,3,6,12,18cpd)的对比敏感度没有显著差别(Mann-Whitneytest P＞0.05).散瞳后Acri.smart 36A组"白天"(75cd/m2亮度)下12c/d和"白天 眩光"下1.5,18c/d的对比敏感度比Acri.smart 46S组大(Mann-Whitney test P＜0.05);Acri.smart 36A组"夜晚"(3cd/m2亮度)1.5,3c/d及"夜晚 眩光"下1.5,6,12c/d的对比敏感度比组高(Mann-Whitney test P＜0.05).3mm瞳孔直径下两组患者的球差无显著差别(Mann-Whitney test P＞0.05),而4mm和5mm瞳孔直径下Acri.smart 36A组的球差明显比Acri.smart 46S组小(Mann-Whitney test,分别为P＜0.05和P＜0.01).结论:Acri.smart 36A非球面人工晶状体植入术后波前像差和对比敏感度比Acri.smart 46S人工晶状体有优势.对于瞳孔直径大的患者选择Acri.smart 36A更具有优势.     

Akreos AO人工晶状体与Tecnis Z9000人工晶状体植入眼后患者视功能对比研究

目的对比植入Akreos AO人工晶状体(intraocular lens,IOL)与Tecnis Z9000 IOL后的波前像差及视功能等指标。方法 82例(100眼)行超声乳化白内障吸出联合IOL植入术的患者,50眼植入Akreos AO IOL(Akreos AO组),50眼植入Tecnis Z9000IOL(Tecnis Z9000组),于术后3个月观察裸眼视力及最佳矫正视力、对比敏感度、波前像差并进行主观问卷调查。结果术后3个月Akreos AO组及Tecnis Z9000组的裸眼视力及最佳矫正视力差异均无统计学意义(均为P>0.05)。Tecnis Z9000组在瞳孔直径为4.0mm、5.0mm、6.0mm下的总体高阶像差及球面像差Z(4,0)均明显低于Akreos AO组(均为P<0.001)。两组在瞳孔直径为4.0mm、5.0mm、6.0mm下的总体三阶像差均方根值差异均无统计学意义(均为P>0.05)。术后3个月,Akreos AO组与Tecnis Z9000组在明视、暗视、明视眩光、暗视眩光下各个空间频率的对比敏感度差异均无统计学意义(均为P>0.05)。术后Akreos AO组患者满意度为95.9%,高于Tecnis Z9000组的81.3%,两组差异有统计学意义(χ2=5.189,P=0.023),术后眩光、光晕及暗处功能视力的不满意率两组差异没有统计学意义。结论虽然Akreos AO IOL与Tecnis Z9000IOL相比保留了患眼的部分球面像差,但植入Akreos AO IOL的患眼仍能够获得满意的术后客观、主观视功能及很高的患者满意度。     

不同设计的非球面人工晶状体植入术后的对比敏感度比较

目的 比较两种不同设计的非球面人工晶状体植入术后患者对比敏感度的改变.方法 选择连续入院并拟由同一临床经验丰富的医师完成白内障超声乳化联合人工晶状体植入手术的患者63例(90只眼),随机分为三组,每组30只眼.组A患者植入前表面非球面修饰的人工晶状体( AMO Tecnis ZA 9003型),组B植入后表面非球面修饰的人工晶状体(Alcon IQ SN60WF型),对照组植入单焦球面人工晶状体( AMO AR40e).术后6个月对三组患者进行不同照明条件下(3 cd/m2,85 cd/m2),四种不同空间频率下(3c/d,6 c/d,12 c/d,18 c/d)的对比敏感度(CS)测定并进行比较.结果 两组非球面晶状体植入的患者术后对比敏感度较球面晶状体植入术的患者更好,其中在低空间频率下( 3c/d 、6c/d)差异有统计学意义(P＜0.05).在眩光条件下,球面晶体植入患者在高空间频率( 18c/d)下的对比敏感度下降(P＜0.05),而非球面晶状体组患者则耐受良好.结论 两种非球面人工晶状体都能获得良好地视功能,相比传统的球面型人工晶状体,新的非球面设计理念可以带来更好地视觉质量.     

Tecnis非球面折叠人工晶状体植入术的临床应用研究

目的:探讨老年性白内障超声乳化联合Tecnis非球面折叠人工晶状体植入的临床效果。方法:回顾性分析了205例289眼Tecnis非球面折叠人工晶状体在超声乳化白内障吸除加人工晶状体植入术中的应用。检查患者术后的视力、人工晶状体的位置及手术并发症的发生情况。随访时间3～9mo。结果:术后3mo,平均裸眼远视力为4.58±0.12,最佳矫正远视力为5.12±0.16。术后晶状体后囊膜混浊22眼。结论:Tecnis折叠人工晶状体植入术可使患者恢复良好的裸眼远视力,并且减少眩光,提高夜间视力,改善人工晶状体眼的视觉质量。     

高度近视白内障植入非球面与球面IOL视觉质量观察

目的：观察高度近视合并白内障植入非球面与球面人工晶状体术后视觉质量。

方法：回顾性分析高度近视合并白内障患者42眼,其中植入非球面IOL(Alcon SN60WF)22眼,植入球面IOL(Alcon SN60AT)20眼,所有病例术后裸眼视力均>0.2,术后6mo对视力、表观调节力、对比敏感度等视功能检查。

结果：术后6mo非球面IOL和球面IOL两组的矫正远视力、矫正远视力后的近视力、表观调节力比较差异均无统计学意义(P>0.05),在暗视及暗视眩光状态下,低、中空间频率非球面IOL组CS和GCS优于球面IOL组,差异有统计学意义(P<0.05),在高频区、明视及明视眩光状态下两组间CS和GCS差异无统计学意义(P>0.05)。

结论：高度近视合并白内障患者非球面IOL植入术后CS和GCS优于球面IOL植入术后,可以改善视觉质量。     

高度近视合并白内障患者不同IOL植入方案的术后视觉质量评估

目的:对双眼微单视植入Tecnis Symfony人工晶状体(IOL)、混合植入Tecnis Symfony IOL与Tecnis ZMB00多焦点IOL、双眼植入AcrySof IQ PanOptix IOL的高度近视合并白内障患者,进行视觉质量评估。方法:采用前瞻性非随机对照研究,选取2020-08/2022-03于包头医学院第一附属医院行双眼超声乳化吸除联合IOL植入术的高度近视合并白内障患者。依据患者所选植入IOL方案不同,分为微单视组、混搭组及三焦组。术后随访3mo,观察指标：术后3mo未矫正远(5m)、中(80、60cm)、近(33cm)距离视力,对比敏感度(CS),未矫正远视力下的离焦曲线,主观视觉质量评分,术后1、3mo光干扰现象。结果:术后3mo三组未矫正远(5m)、中(60cm)距离视力均无差异(P>0.05);微单视组未矫正中(80cm)距离视力与混搭组相近,且均优于三焦组(P<0.05);混搭组未矫正近(33cm)距离视力表现最好,三焦组次之,微单视组最低(均P<0.05)。三焦组暗光加眩光CS(12、18c/d)最优秀,混搭组次之,微单视组最...     

非球面与球面人工晶状体植入术后高阶像差及对比度视力的比较

目的:比较非球面和球面人工晶状体植入术后波前像差、裸眼远视力、最佳矫正远视力、对比度视力的差异。方法:年龄相关性白内障患者46例50眼,将其随机分成两组,球面人工晶状体组(A组)23例24眼术中植入ACR6DSE球面人工晶状体;非球面人工晶状体组(B组)23例26眼术中植入具有负球面像差Acri.Smart36A非球面人工晶状体。术后3mo,观察两组患者的裸眼视力、最佳矫正视力、暗背景(25cd/m2)和高亮背景(255cd/m2)下的对比度视力、瞳孔直径(6mm)时的球面像差、彗差和高阶像差的均方根是否存在差异。结果:两组患者术后裸眼远视力、最佳矫正远视力比较差异无统计学意义,亮背景下各对比度视力以及暗背景下100%,25%对比度视力两组比较差异无统计学意义,暗背景下5%,10%低对比度时B组视力好于A组。瞳孔直径6mm时,B组高阶像差的均方根(RMS)、球差、彗差和A组比较差异均有统计学意义,B组RMS、球差、彗差低于A组。结论:Acri.Smart36A非球面人工晶状体植入术后与ACR6DSE球面人工晶状体比较可以明显的减少患者的高阶像差,改善患者的术后暗环境下的低对比度视力。     

Visual acuity and contrast sensitivity comparison between Tecnis and AcrySof SA60AT intraocular lenses: A multicenter randomized study

PURPOSE: To evaluate best corrected visual acuity (BCVA) and photopic and mesopic contrast sensitivity in pseudophakic patients implanted either with the aspheric intraocular lens (IOL) designed to correct for corneal spherical aberration or with a conventional IOL. SETTING: Three surgical centers participated this prospective randomized masked comparative study. METHODS: Thirty eyes of 30 patients after aspheric lens implantation (Pfizer/Pharmacia Tecnis Z9000) were compared with 30 eyes of 30 age-matched patients after conventional lens implantation (Alcon AcrySof SA60AT). Two to three months after surgery, best spectacle corrected distance visual acuity was measured using the Early Treatment Diabetic Retinopathy Study chart. Contrast sensitivity was measured by sinusoidal grating charts for distance at photopic (85 cd/m(2)) and mesopic (6 cd/m(2)) luminance level with optical correction in place. Tested spatial frequencies were 1.5, 3, 6, 12, and 18 cycles per degree (cpd). RESULTS: The mean BCVA was -0.053 +/- 0.044 logMAR in eyes with the aspheric Tecnis IOL and 0.006 +/- 0.059 logMAR in eyes with the conventional AcrySof IOL (P=.0001). Eyes with the aspheric IOL showed better contrast sensitivity at spatial frequencies of 3 cpd (P<.05) and 6, 12, and 18 cpd (P<.01) in photopic and in mesopic conditions. Peak improvement occurred at 18 cpd and was 36% (0.29 log units) in photopic and 54% (0.27 log units) in mesopic conditions. CONCLUSIONS: The aspheric Tecnis IOL yielded better BCVA and better distance contrast sensitivity than the conventional IOL. The differences were clinically significant for higher spatial frequencies. The results give some suggestions for further studies.     

人工晶状体前表面非球面化改良能够改善视觉质量

目的:根据对比敏感度结果比较前表面改良的非球面Tecnis Z9000 IOL和标准的911A IOL的光学性能.方法:Tecnis Z9000硅凝胶IOL和911A IOL具有共同的基本特征包括12mm总长度、三片直边双凸6mm的光学直径和成角的聚丙乙烯C襻.对连续10例双侧白内障患者(20眼)进行了随机前瞻研究,所有患者都接受了白内障超声乳化手术并随机于1眼植入Tecnis Z9000IOL,另1眼在术后6wk内植入911A IOL作为对照,术后6wk进行对比敏感度检查,所得数据采用秩和检验进行比较.结果:随机植入Tecnis IOL组的术前平均最佳Snellen矫正视力为6/8.5(0.70),植入911A I0L组为6/9.4(0.64),所有20眼术后最佳矫正视力都达到了6/6(1.0).术后对比敏感度分析发现两组在12和18 cpd(明视)、1.5和3 cpd(暮视)以及1.5和3 cpd(暮视伴眩光)均有统计学差异(P＜0.05)结论:Tecnis Z9000 I0L被证明其对比敏感度在明视高空间频率和暮视低空间频率方面均显著优于911A IOL.     

Improved functional vision with a modified prolate intraocular lens

PURPOSE: To evaluate whether the Tecnis Z9000 intraocular lens (IOL) (Pfizer) with a modified prolate anterior surface provides better quality of vision than a conventional spherical IOL. SETTING: Oregon Eye Institute, Eugene, Oregon, USA. METHODS: Patients presenting for cataract surgery who were randomly assigned to receive a Tecnis Z9000 IOL (Pfizer) or a Sensar OptiEdge AR40e IOL (AMO) in 1 eye were followed for 3 months postoperatively. The patient could elect to have the same type of IOL implanted in the fellow eye. The results of sine-wave grating contrast sensitivity testing under mesopic and photopic conditions were compared interindividually. RESULTS: Monocular comparison was made between the 2 IOL groups, which comprised 15 patients each. The Tecnis IOL provided significantly better contrast sensitivity at 6 cycles per degree (cpd) under photopic conditions and at 1.5 and 3 cpd under mesopic conditions. Seven patients with a Tecnis IOL and 9 patients with an AR40e IOL had subsequent implantation in the fellow eye. In all eyes, including fellow eyes, having IOL implantation, the Tecnis provided significantly better contrast sensitivity at 3 and 6 cpd under photopic conditions and at 1.5, 3, and 6 cpd under mesopic conditions. The mean contrast sensitivity in fellow eyes showed that the Tecnis IOL produced significantly better results at some spatial frequencies. CONCLUSIONS: Results show the Tecnis IOL with a modified prolate anterior surface may produce better contrast sensitivity than a standard spherical IOL under mesopic and photopic conditions. Because contrast sensitivity testing correlates well with functional vision, a goal of future research should be to evaluate patient performance using functional tests such as driving simulation.     

白内障手术植入球面和非球面人工晶状体后视觉质量的比较

目的 评估白内障手术植入负球差设计的非球面折叠式人工晶状体(Intraocularlen,IOL)后的视觉质量.方法 取112例(152只眼)白内障超声乳化手术患者按数字表法被分为三组,第一组植入TecnisZ9003IOL(美国 AMO 公司),第二组植入AcrysofIQIOL(美国Alcon公司),第三组植入HQIOL(法国Hexavision公司).于术后一周、一月、三月分别检测裸眼视力、最佳矫正视力,无眩光及有眩光环境下的白天夜晚对比敏感度,同时检测全眼的球差、第三、第四、第五阶像差均方根(root mean square,RMS)、总高阶像差(higher-order aberration,HOA)RMS以及总像差(total ocular aberration,TOA)RMS.结果 术后三次随访三组患者的裸眼视力和最佳矫正视力差异均没有统计学意义.术后一周、一月时三组白天对比敏感度未见显著差异,术后一月、三月时TecnisZ9003组和AcrysofIQ组的夜间对比敏感度在中、低空间频率上明显好于HQ组,同时术后三月时该两组的白天对比敏感度亦好于HQ组,差异均具有统计学意义(P＜0.05).另外,术后三次随访TecnisZ9003组和AcrysofIQ组全眼的球差、RMS4均低于HQ组,在术后一月、三月时HOA较HQ组低,同时术后三次随访在瞳孔直径6mm大小时TOA亦较低,差异均有统计学意义(P＜0.05).结论 植入负球差设计的非球面人工晶状体可提高白内障患者术后对比敏感度,降低球差和高阶像差,获得更好的视觉质量.     

非球面人工晶状体植入术后视觉质量对比分析

目的:评价3种非球面人工晶状体(AcrySof SN60WF、TecnisZ9001和KS-3Ai)植入术后的视觉质量。方法:采用前瞻性随机对照研究方法,收集我院老年性白内障手术患者88例126眼,平均年龄67.3±8.7岁,将入选患者按植入不同的人工晶状体(Intraocular lens,IOL)随机分为4组:AcrySofSN60WF(IQ)组(23例33眼)、TecnisZ9001组(23例33眼)、KS-3Ai组(20例29眼),SN60AT球面人工晶状体组为对照组(22例31眼)。术后随访3mo,观察指标:裸眼视力(uncorrected visual acuity,UCVA)及最佳矫正视力(best corrected visual acuity,BCVA),眼压,等效球镜度数,角膜Q值,瞳孔直径,6mm全眼球总高阶像差及四阶球差均方根值(root mean square,RMS),夜光、昼光及夜眩光3种视觉条件下的对比敏感度(contrast sensitivity,CS)。结果:术后各组的UCVA、BCVA、等效球镜度数和瞳孔直径均无统计学差异。总高阶像差和四阶球差RMS:非球面组低于球面组,差异具有统计学意义(P<0.05);非球面组间比较无统计学差异。术后角膜Q值与球差成正相关(r=0.183,P<0.05)。术后对比敏感度:与球面IOL相比,IQ,Tecnis可提高术后3种视觉条件下的CS,KS-3Ai可提高术后夜光、夜眩光两种视觉条件下的CS;非球面IOL组间比较,IQ组在昼光、夜眩光视觉条件下的CS好于Tecnis组和KS-3Ai组,TECNIS组和KS-3Ai组之间在3种视觉条件下均无统计学差异。结论:3种非球面IOL均可有效地减少术眼的总高阶像差和四阶球差。3种非球面IOL均可以提高术眼术后的CS,IQ组在昼光、夜眩光视觉条件下的CS与Tecnis组和KS-3Ai组相比较差异具有统计学意义,Tecnis组和KS-3Ai组之间在3种视觉条件下的CS均无统计学差异。     

白内障手术植入球面和非球面人工晶状体后视觉质量的比较

目的 评估白内障手术植入负球差设计的非球面折叠式人工晶状体(Intraocularlen,IOL)后的视觉质量.方法 取112例(152只眼)白内障超声乳化手术患者按数字表法被分为三组,第一组植入TecnisZ9003IOL(美国 AMO 公司),第二组植入AcrysofIQIOL(美国Alcon公司),第三组植入HQIOL(法国Hexavision公司).于术后一周、一月、三月分别检测裸眼视力、最佳矫正视力,无眩光及有眩光环境下的白天夜晚对比敏感度,同时检测全眼的球差、第三、第四、第五阶像差均方根(root mean square,RMS)、总高阶像差(higher-order aberration,HOA)RMS以及总像差(total ocular aberration,TOA)RMS.结果 术后三次随访三组患者的裸眼视力和最佳矫正视力差异均没有统计学意义.术后一周、一月时三组白天对比敏感度未见显著差异,术后一月、三月时TecnisZ9003组和AcrysofIQ组的夜间对比敏感度在中、低空间频率上明显好于HQ组,同时术后三月时该两组的白天对比敏感度亦好于HQ组,差异均具有统计学意义(P＜0.05).另外,术后三次随访TecnisZ9003组和AcrysofIQ组全眼的球差、RMS4均低于HQ组,在术后一月、三月时HOA较HQ组低,同时术后三次随访在瞳孔直径6mm大小时TOA亦较低,差异均有统计学意义(P＜0.05).结论 植入负球差设计的非球面人工晶状体可提高白内障患者术后对比敏感度,降低球差和高阶像差,获得更好的视觉质量.     

Prospective randomized study of clinical performance of 3 aspheric and 2 spherical intraocular lenses in 250 eyes

PURPOSE: To compare the quality of vision with aspheric and spherical intraocular lenses (IOLs) in pseudophakic patients. METHODS: This prospective, comparative, randomized study included 250 eyes of 125 patients with bilateral cataracts. Patients were randomly assigned to receive either IOLs with a spherical biconvex optic (Acrysof SN6OAT [Alcon] or Sensar AR40e [Advanced Medical Optics, AMO]) or IOLs with an aspheric optic (Acrysof IQ SN6OWF [Alcon], Tecnis Z9000 [AMO], or Sofport L161AO [Bausch & Lomb]). Ophthalmologic examination including best spectacle-corrected visual acuity, pupil size, ocular dominance investigation, contrast sensitivity under mesopic and photopic conditions, and wavefront analysis was performed 2 months postoperatively. RESULTS: Aspheric IOLs showed better contrast sensitivity compared to spherical IOLs at spatial frequencies of 6, 12, and 18 cycles per degree (cpd) under photopic conditions and at all spatial frequencies under mesopic conditions. There was no significant difference among the three aspheric IOLs at all spatial frequencies under either photopic or mesopic conditions. Mean total spherical aberration was statistically lower in dominant eyes with aspheric IOLs (0.05 +/- 0.06, 0.11 +/- 0.1, and 0.19 +/- 0.08 pm for the Tecnis Z9000, Acrysof IQ SN6OWF, and Sofport L161AO, respectively) compared with eyes with spherical IOLs (0.62 +/- 0.24 and 0.46 +/- 0.19 microm for the Acrysof SN6OAT and Sensar AR40e, respectively) for a 5-mm pupil diameter. CONCLUSIONS: The aspheric IOLs had less wavefront aberrations and performed better under both photopic and mesopic contrast sensitivity compared to the spherical IOLs. These findings confirm it is possible to improve the optical performance of IOLs by modifying the surfaces.     

Improving quality of vision with an anterior surface modified prolate intraocular lens: A prospective clinical trial

AIM: To compare the optical performance of the anterior surface modified prolate Tecnis Z9000 IOL with the standard 911A IOL in terms of contrast sensitivity outcomes. · METHODS: The Tecnis Z9000 silicone IOL shares the same basic characteristics with the 911A IOL including a 12.0mm overall diameter, 3-piece equiconvex 6.0mm optic and angulated cap C polyvinylidene fluoride haptics. This is a randomized prospective study that involved ten consecutive patients (20 eyes) with bilateral cataracts. Each patient underwent phacoemulsification and received randomly the Tecnis Z9000 IOL in one eye and the control (911A IOL) in the fellow eye within 6 weeks period of one another. Contrast sensitivity was measured after six postoperative weeks. The collected data were analyzed through using Mann Whitney U test. · RESULTS: The mean pre-operative best spectacle corrected Snellen visual acuity in the eyes that were randomly selected to receive the Tecnis IOL was 6/8.5 (0.70) and in the eye selected to receive the 911A IOL was 6/9.4(0.64). Postoperatively all 20 eyes achieved best corrected Snellen visual acuity of 6/6 (1.0). Postoperative contrast sensitivity testing showed statistically significant differences (P <0.05) between the two IOLs at 12 and 18 cpd under photopic, at 1.5 and 3 cpd under mesopic, and at 1.5 and 3 cpd under mesopic with glare conditions. · CONCLUSION: The Tecnis Z9000 IOL proved to have statistically significant superior contrast sensitivity to the 911A IOL at high spatial frequencies under photopic conditions and at low spatial frequencies under mesopic and mesopic with glare conditions.     

Retinal image contrast and functional visual performance with aspheric, silicone, and acrylic intraocular lenses. Prospective evaluation

PURPOSE: To compare the effects of an aspheric intraocular lens (IOL) (Tecnis Z-9000, Pharmacia Corp.) with those of conventional silicone (AA4207VF, Staar Surgical) and acrylic (AcrySof SA60AT, Alcon Surgical) lenses on retinal imaging and functional visual performance. SETTING: Eye Laser Center, Tucson, Arizona, USA. METHODS: In this prospective study, 221 eyes of 156 patients were randomly assigned to receive 1 of 3 IOLs. Visual acuity was measured preoperatively and 1 day, 1 and 3 weeks, and 1, 3, and 6 months postoperatively. Fundus photography and photopic and mesopic functional acuity contrast testing were performed preoperatively and 3 months postoperatively. RESULTS: The differences in the preoperative and postoperative spherical and astigmatic refractive errors and best corrected visual acuity among groups were not statistically significant. The postoperative uncorrected visual acuity was best in the aspheric group in the first month. Functional acuity contrast testing showed the aspheric IOL group had a 38% to 47% increase in photopic vision, 38% in photopic with glare, 43% to 100% in mesopic, and 9% to 100% in mesopic with glare. There was no increase in photopic vision in the acrylic group but increases of 38% in photopic with glare, 25% to 50% in mesopic, and 36% to 50% in mesopic with glare. The spherical silicone IOL group had no increase in contrast testing from preoperatively. Digital analysis of retinal imaging showed increased threshold luminance levels in the aspheric group (range 116 to 208 cd/m2) and a 4-fold increase in image contrast. CONCLUSIONS: All 3 IOLs led to improved visual acuity after cataract surgery. The aspheric IOL provided a significant improvement in retinal image contrast and visual performance measured by visual acuity and functional acuity contrast testing. This improvement was greatest in night vision and night vision with glare compared to the performance of conventional spherical silicone and acrylic IOLs.     

Comparison of clinical outcomes with three different aspheric intraocular lenses

Acta Ophthalmol. 2011: 89: 40–46

Abstract.

Purpose: To compare the quality of vision achieved with different aspheric intraocular lens (IOL) implants. Methods: This prospective, comparative and randomized study included 90 eyes that underwent phacoemulsification and implantation with one of three different aspheric IOLs. Patients were assigned randomly to receive one type of aspheric IOL: Tecnis Z9003^® (Advanced Medical Optics, Santa Ana, California, USA) (Group A), Acrysof IQ SN60WF^® (Alcon Laboratories, Fort Worth, Texas, USA) (Group B) or Akreos ADAPT‐AO^® (Bausch & Lomb, Rochester, New York, USA) (Group C). Ophthalmic examinations, including uncorrected visual acuity, best spectacle‐corrected visual acuity (BCVA), refractive error, wavefront analysis, contrast sensitivity under mesopic and photopic conditions, and a subjective questionnaire, were performed postoperatively. Results: The mean BCVA, mean refractive error and high‐order aberrations were not significantly different among the three groups. The spherical aberrations were 0.0021 ± 0.096 for group A, 0.048 ± 0.071 for group B and 0.11 ± 0.089 for group C, indicating a significantly lower magnitude in group A (p = 0.012). In addition, group A showed significantly better results in contrast sensitivity under mesopic (p = 0.042) and photopic (p = 0.047, 0.049) conditions at low spatial frequencies. Nevertheless, postoperative patient satisfaction was not different among the three groups. Conclusion: The Tecnis Z9003^® IOL reduced spherical aberrations and improved contrast sensitivity under mesopic and photopic conditions at low spatial frequencies. Nevertheless, the final visual quality was not different among the three groups.