Comparison of pseudophakic visual quality in spherical and aspherical intraocular lenses

Objective: This study compares the visual performance of spherical and aspherical intraocular lenses (lOLs) by measuring higher-order aberration and contrast sensitivity (CS) values.Design: Prospective controlled study.Participants: Fifty-seven patients with age-related cataract (61 eyes).Methods: Patients were randomly allocated to 1 of 3 groups and implanted with either aspherical IOLs, Acrysof IQ (SN60WF) or Tecnis Z9001, or a spherical IOL, Acrysof Natural. Patients underwent routine examinations, including visual acuity, slit-lamp checks, and best-corrected visual acuity (BCVA), as well as measurement of higher-order aberrations and CS values, preoperatively and at 1 week, 1 month, and 2 months postoperatively.Results: All the patients had a BCVA better than 20/30 postoperatively. The spherical aberrations of the IQ group and Tecnis group were both lower than in the Natural (control) group (IQ: p <Tecnis: p < 0.05); there was no significant difference in coma and higher-order aberration. No statistically significant difference was found in spherical aberration, coma, or higher-order aberration between the IQ and Tecnis groups. Under glare conditions, the CS values of the 2 aspherical IOLs were obviously better (IQ: p < 0.05; Tecnis: p < 0.05) than the CS value of the spherical IOL group at low frequency (IQ: 6.3°, Tecnis: 4.0°); under non-glare conditions there was a significant difference in CS values between the aspherical IOL groups and the control group (IQ: p <Tecnis: p < 0.01) at low frequency (both 6.3°). There was no statistical difference between the IQ and the Tecnis groups with or without glare.Conclusions: An aspherical IOL can effectively reduce spherical aberration after cataract surgery, enhance CS values, and improve visual quality compared with traditional spherical IOLs for age-related cataract. However, there was no statistically significant difference in postoperative aberration and CS values between the Acrysof IQ and Tecnis Z9001 aspherical IOLs.     

Ocular wavefront analysis and contrast sensitivity in eyes implanted with AcrySof IQ or AcrySof Natural intraocular lenses

Purpose: This study aimed to compare ocular wavefront aberrations for pupil diameters of 4 mm and 6 mm, and contrast sensitivity, in eyes with AcrySof IQ and AcrySof Natural intraocular lenses (IOLs). Methods: Sixty eyes of 60 patients were enrolled in this prospective randomized study. After phacoemulsification the eyes received either AcrySof IQ SN60WF or AcrySof Natural SN60AT IOLs. One month after surgery, all patients underwent complete ophthalmological examination including corneal topography, wavefront analysis for pupil diameters of 4 mm and 6 mm, and contrast sensitivity measurements with the CSV 1000E instrument under photopic and mesopic conditions with and without glare. Results: There was no statistically significant difference between groups in age, sex or other preoperative ocular characteristics (p > 0.05). Patients with AcrySof IQ IOLs had higher contrast sensitivity at 6 c.p.d. under photopic conditions, at 6 c.p.d. and 18 c.p.d. under mesopic conditions, and at 6 c.p.d., 12 c.p.d. and 18 c.p.d. under mesopic conditions with glare (p < 0.05). Corneal spherical aberration was 0.273 ± 0.074 μm in the AcrySof Natural group and 0.294 ± 0.086 μm in the AcrySof IQ group (p = 0489). Ocular spherical aberration was 0.362 ± 0.141 μm and 0.069 ± 0.043 μm (p < 0.001) for 6‐mm diameter pupils and 0.143 ± 0.091 μm and 0.017 ± 0.016 μm (p < 0.001) for 4‐mm diameter pupils, with AcrySof Natural and AcrySof IQ IOLs, respectively. There were no significant differences in other higher‐order aberrations between the groups (p > 0.05). Conclusions: Aspherical AcrySof IQ IOLs significantly reduced spherical aberration for pupil diameters of both 4 mm and 6 mm and also improved contrast sensitivity more than spherical AcrySof Natural IOLs, especially in mesopic conditions.     

Clinical study of Acrysof IQ aspheric intraocular lenses

Purpose: To determine whether implantation of an aspheric intraocular lens (SN 60 WF Alcon) results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. Methods: Randomized, prospective study. 260 patients/eyes were randomized to receive two intraocular lens types: Alcon Acrysof Natural (136 eyes) and Acrysof IQ (124 eyes). Quality of vision was measured by visual acuity and contrast sensitivity under mesopic and photopic conditions. Ocular aberrations for 4.0‐ and 6.0‐mm pupil were measured with Allegretto Wavelight Analyzer. All ophthalmologic were performed 7, 30 and 90 days postoperatively. Visual function index (VF‐14) questionnaires for cataract symptoms were performed 90 days after surgery by all the patients. Results: After 90 days, all eyes had mean postoperative best spectacle‐corrected visual acuity 0.75. Eyes with the Acrysof IQ had significantly higher contrast sensitivity than eyes with the Acrysof Natural at high and middle spatial frequencies. A significant reduction in spherical aberration after Acrysof IQ implantation was achieved. The Acrysof IQ also had lower values of high‐order aberration with 4.0‐ and 6.0‐mm pupil when compared with the AcrySof Natural. Conclusion: Results show the aspheric Acrysof IQ induced significantly less high‐order aberration and spherical aberration compared with the Acrysof Natural. Contrast sensitivity revealed better values with the Acrysof IQ intraocular lens.     

Acri.Smart 36A非球面人工晶状体临床应用研究

目的探讨Acri.Smart36A非球面人工晶状体对人工晶状体眼视觉质量和波前像差的影响。方法选择老年性白内障患者24例30眼,随机分为2组,植入非球面设计的Acri.Smart36A人工晶状体(Acri.Smart36A组)15眼和植入球面设计的Acri.Smart46S人工晶状体15眼(Acri.Smart46S组),比较两组术后3个月最佳矫正视力、对比敏感度(眩光和无眩光条件下,6.3°、4.0°、2.5°、1.6°、1.0°空间频率下)、像差(尤其眼内球差)的差异。结果术后3个月,Acri.Smart36A组最佳矫正视力为0.87±0.16,Acri.Smart46S组为0.85±0.18,差异无统计学意义(P>0.05)。术后Acri.Smart36A组患者对比敏感度除眩光条件下1.0°及无眩光条件下1.6°空间频率之外其余各空间频率均较Acri.Smart46S组好(均为P<0.05)。术后Acri.Smart36A组总球差为(-0.060±0.355)μm,眼内球差为(-0.283±0.177)μm;Acri.Smart46S组总球差为(0.145±0.137)μm,眼内球差为(0.072±0.159)μm,差异均有统计学意义(均为P<0.05)。结论相较球面人工晶状体,Acri.Smart36A非球面人工晶状体能减少眼内球差,提高对比敏感度、眩光敏感度,提高视觉质量。     

AcrySof IQ人工晶状体植入术的临床效果观察

目的:探讨白内障超声乳化联合蓝光滤过型非球面人工晶状体植入术的临床效果。方法:年龄相关性白内障患者80例(80眼),术中植入AcrySof IQ人工晶状体为观察组,植入AcrySof Natural人工晶状体为对照组。观察术后1wk不同视标对比度的视力;使用主观像差仪检查实验组术后1mo的像差,依35项Zernike系数计算总像差及4阶像差的均方值(root means quare,RMS),比较实验组与对照组间的差异。结果:术后1wk,视标对比度为100%时,两组间差异无统计学意义(P<0.05)。对比度为25%时,两组间差异有统计学意义(P>0.05)。术后1mo,实验组与对照组总体像差的RMS均值分别为0.84±0.21μm及1.44±0.42μm,两者之间的差异有统计学意义。实验组、对照组4阶像差(球差)的RMS均值为0.58±0.18μm、1.14±0.37μm,两者之间的差异有统计学意义。结论:非球面人工晶状体可以减少术眼光学像差(尤其是球差),获得更好的低对比度视力,从而提高术后的视觉质量。     

Analysis of glistenings in hydrophobic acrylic intraocular lenses on visual performance

AIM:To assess patients’ visual performance with glistenings in one piece soft hydrophobic acrylic intraocular lenses (IOLs) (Alcon) 2 years postoperatively.METHODS:This cross section trial included 120 eyes with one piece IOL at 2 years postoperatively. Glistening was classified in 4 groups, ranging from 0 (none) to 3 (most evident) according to their severity in IOLs optics observed under a slit lamp. All eyes underwent a uncorrected and best-corrected visual acuity evaluation (UCVA and BCVA, LogMAR scale), a complete clinical examination, a contrast sensitivity (CS) evaluation by F.A.C.T chart, and a visual field test by Humphrey Field AnalyzerⅡ(HFA). One-way ANOVA was used for quantitative data, while Pearson χ² test was used for qualitative data to analyze the visual function of 4 glistening groups.RESULTS: Totally 120 eyes were enrolled with 30 eyes in each glistening group. There was no statistical correlation between glistening grades and patients’ age, IOLs power, postoperative UCVA and BCVA (P>0.05). Quantificationally, CS values among each group were not statistically different. However, qualitative analysis showed there were more eyes in grade 3 group than in grade 0 group having abnormally declined CS at high spatial frequency (10% vs 36.7% at 18 cpd, P=0.029; 6.7% vs 26.7% at 12 cpd, P=0.013). Mean deviation (MD) of the visual field test was -2.14±2.31, -1.97±2.23, -3.02±3.17, -4.12±3.38 in group 0 to 3 respectively. There was a significant decrease in the most serious glistenings group (P =0.018).CONCLUSION:Glistenings may potentially have an impact on contrast sensitivity at high spatial frequencyand MD in visual field test.     

蓝光滤过型非球面人工晶状体植入术后视觉质量的临床研究

目的观察行超声乳化白内障吸除联合植入蓝光滤过型非球面人工晶状体（HOYA PY-60AD）眼的术后视觉质量。设计前瞻性临床研究。研究对象57例（57眼）年龄相关性白内障患者。方法接受超声乳化白内障吸除术的年龄相关性白内障患者57例（57眼）按就诊顺序登记及随机表法将患者分为2组,术中分别植入非球面人工晶状体HOYAPY-60AD（29眼）和球面人工晶状体HOYA AF-1（UY）（28眼）。术后随访3个月。随访时进行一般眼科检查,包括视力、眼压、眼前节及眼底,并记录术后3个月时的裸眼视力（UCVA）、最佳矫正视力（BCVA）、低对比度视力（ETDRS低对比度视力表）、对比敏感度（OPTEC6500,明视、明视眩光、间视和间视眩光）并填写调查问卷（Catquest-9SF）。主要指标UCVA,BCVA,低对比度视力,对比敏感度和调查问卷分值。结果术后3个月,非球面组患者明视（400Lux）条件下5％对比度视力（0．35±0．13）及间视（30Lux）条件下5％（0．49±0．13）和25％（0．25±0．12）对比度视力均好于球面组,分别为（0．43±0．15）、（0．61±0．12）、（0．32±0．14）,差异有统计学意义（P均≤0．05）,间视及间视＋眩光条件下低中频（1．5c／d、3c/d、6c／d、12c/d）的对比敏感度非球面组均好于球面组,差异有统计学意义（P均40．05）。两组患者UCVA、BCVA及调查问卷分值均无统计学差异（P均≥0．05）。结论非球面人工晶状体能够提供较好的低对比度视力和暗环境下的对比敏感度,提示非球面人工晶状体能够提供较好的视觉质量。（眼科,2010,19：89-92）     

Comparison of visual function following implantation of Acrysof Natural intraocular lenses with conventional intraocular lenses

BACKGROUND: Recently an intraocular lens (IOL) has been introduced which blocks blue light. As blocking blue light may be to the patient's detriment, this study was designed to evaluate visual function following implantation of a blue-blocking (Acrysof Natural) IOL. METHODS: Patients were recruited for this non-randomized controlled interventional study, from those attending a private rural ophthalmology clinic for cataract surgery (n = 93). Only those who had previously had a conventional IOL implanted into one eye were offered an Acrysof Natural IOL for the second eye. Postoperatively patients underwent refracted Snellen visual acuity, contrast sensitivity using a CSV-1000E instrument and colour vision testing using a Farnsworth D-15 test, with a subset (n = 20) undergoing a Farnsworth-Munsell 100-Hue test. Results were then compared between eyes. Finally, a subset (n = 63) completed a survey designed to assess the subjective impact of the Acrysof Natural IOL. RESULTS: There were no statistically significant differences between eyes implanted with conventional IOLs compared with Acrysof Natural IOLs for visual acuity (t = 0.57; P = 0.57), contrast sensitivity (t = 0.43; P = 0.67 for 3 cycles per degree [cpd], t = 0.56; P = 0.58 for 6 cpd, t = 0.09; P = 0.93 for 12 cpd and t = 0.16; P = 0.87 for 18 cpd) or colour vision with the Farnsworth D-15 (Chi(2) = 0.38; P = 0.55) or the Farnsworth-Munsell 100-Hue test t = 0.34; P = 0.74). Most subjects reported that they could not tell a difference between the two IOLs subjectively or that any difference experienced was not significant. CONCLUSION: Our sample did not show any significant differences between eyes implanted with conventional IOLs and the Acrysof Natural IOL. We would suggest that the Acrysof Natural IOL may be used without any significant difference in visual function.     

Comparison of the AcrySof IQ aspheric blue light filter and the AcrySof SA60AT intraocular lenses

PURPOSE: The development of aspheric intraocular lenses (IOL) designed to compensate for the positive spherical aberration of the cornea has been shown to improve the image quality of pseudophakic eyes. This prospective clinical study compared an aspheric IOL with a blue light filter (AcrySof IQ) with its spherical platform--the SA60AT IOL with conventional optic. METHODS: After uneventful phacoemulsification, 42 and 20 eyes were implanted with the AcrySof IQ aspheric lens and the SA60AT, respectively. Six weeks after surgery, higher order aberrations, visual acuity, contrast sensitivity, depth of focus, pupil size, and corneal asphericity were assessed. RESULTS: Visual acuity was good with both IOLs. A significant difference was found regarding spherical aberration. Mean values of spherical aberration, calculated for a 5-mm pupil were 0.20 +/- 0.06 microm with the SA60AT and 0.04 +/- 0.05 microm with the AcrySof IQ lens. Contrast sensitivity was significantly superior in the AcrySof IQ group in 7 of 15 measurement conditions. Asphericity of the cornea proved to be correlated with postoperative ocular spherical aberration. CONCLUSIONS: The aspheric optic design of the AcrySof IQ results in significant reduction of postoperative ocular spherical aberration and improved contrast vision. Measuring the corneal asphericity allows estimation of postoperative ocular spherical aberration.     

Centripetal lens epithelial cell migration: a prospective study of the Alcon SA60AT intraocular lens

PURPOSE: To evaluate prospectively the incidence and severity of centripetal lens epithelial cell migration (CLECM) onto the anterior surface of the Alcon SA60AT intraocular lens (IOL). METHODS: One hundred and four consecutive cases of SA60AT IOL implantations were prospectively evaluated. At the 1-month postoperative visit, best corrected visual acuity (BCVA) was obtained. Following maximal pupillary dilatation, the extent of CLECM was assessed using a simplified grading scale (0-4). The centrality of the lens within the capsular bag was recorded. Patients with the highest grade of CLECM were recalled for reassessment at a minimum of 3 months. RESULTS: Centripetal lens epithelial cell migration data were obtained on 99 patients. Of these, 94% demonstrated CLECM of varying severity at 1 month postoperatively. The severity was low grade in 54% of patients (29% grade 1, 24% grade 2), and high grade in 40% of patients (16% grade 3, 24% grade 4). BCVA results were good (91.9% 6/6 or better) and did not correlate with CLECM grade. Operative capsulorhexis size did not correlate with the severity of CLECM. The lens was well-centred in 91 of 92 patients in whom lens position was assessed. Twenty-three patients with grade 4 CLECM at 1 month were brought back for reassessment (3.5-13 months postoperatively) and 18 of these demonstrated complete regression of CLECM (to grade 0). CONCLUSIONS: There is a high incidence and severity of CLECM 1 month postoperatively using the Alcon SA60AT IOL. There was no significant correlation between CLECM grade and either BCVA at 1 month, capsulorhexis size or lens centration. CLECM appears to be a frequent, benign and transient event with this lens.     

Contrast visual acuity after multifocal intraocular lens implantation:aspheric versus spherical design

AIM: To evaluate contrast visual acuity (CVA) after implantation of an aspheric apodized diffractive intraocular lens (IOL) or a spherical apodized diffractive IOL in cataract surgery. METHOD: This prospective randomized controlled study with a 12-month follow-up compared the results of cataract surgery with implantation of an aspheric AcrySof ReSTOR SN6AD3 IOL (30 eyes) and a spherical AcrySof ReSTOR SN60D3 IOL (30 eyes). CVA with best distance correction was measured at 4 contrast levels (100%, 25%, 10% and 5%) under 3 levels of chart luminance [250, 85 and 25 candelas per square meter (cd/m²)] using a multi-functional visual acuity tester (MFVA-100)． RESULTS:At 12 months after surgery, there were no statistically significant differences in 100% CVA and 25% CVA under 250cd/m² (P100%=0.875 and P25%=0.057) and 85cd/m² (P100%=0.198 and P25%=0.193) between the aspheric group and the spherical group. However, the 10% CVA and 5% CVA were significant better in aspheric group than spherical group under 250cd/m² (P10%=0.042 and P5%=0.007) and 85cd/m² (P10%=0.002 and P5%=0.039). Under the luminance level of 25cd/m², no significant differences was found in the 100% CVA between the 2 group (P100%=0.245), while aspheric group had better visual acuity in the remaining 3 contracts (P25%=0.023, P10%=0.026 and P5%=0.002, respectively). CONCULSION:The aspheric AcrySof ReSTOR SN6AD3 IOL provided patients with better low-contrast visual acuity than the spherical AcrySof ReSTOR SN60D3 IOL.     

Postoperative visual performance with a bifocal and trifocal diffractive intraocular lens during a 1-year follow-up

AIM: To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens (IOL) during a 12-month follow-up. METHODS: Prospective comparative study including 75 eyes of 38 patients (44-70y) undergoing uneventful cataract surgery. Each patient was randomly assigned to one type of IOL, bifocal (35 eyes) or trifocal (40 eyes). Visual, refractive, and contrast sensitivity changes were evaluated in a 12-month follow-up. The binocular defocus curve was also measured at 12mo postoperatively. RESULTS: No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities (P≥0.276). Postoperative corrected near visual acuity (33 cm) was significantly better in the trifocal group during all follow-up (P≤0.004) as well as 6-month uncorrected near (P=0.008) and distance-corrected near visual acuities (P=0.016) (33/40 cm). Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group (P<0.001), which was consistent with differences among groups in binocular defocus curve. Differences among groups in contrast sensitivity were minimal, being only significant at 6 months for some low to medium spatial frequencies (P≤0.006). CONCLUSION: Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up, with a clear benefit of the trifocal IOL for the intermediate vision.     

AcrySof ReSTOR及Tecnis ZMB00多焦点人工晶状体植入术后视觉质量的比较

目的 比较植入AcrySof ReSTOR及Tecnis ZMB00多焦点人工晶状体(muhifocal intraocular lens,MIOL)术后患者的视觉质量.方法 回顾性病例对照分析2012年1月至2013年6月期间在我院眼科行白内障超声乳化联合MIOL植入术的患者32例(43眼),根据植入的MIOL不同分为两组,分别为植入AcrySof ReSTOR+4 D MIOL的A组,17例(22眼);植入TecnisZMB00 +4 D MIOL的T组,15例(21眼).术后随访3个月,使用标准对数视力表测量裸眼远视力(5 m)及Colenbrander Mixed Contrast视力测试卡测量中距离视力(66 cm)及近视力(40 cm).术后3个月时测量明视、暗视和眩光状态时不同空间频率下的对比敏感度,同时对患者视觉干扰、满意度及脱镜率进行问卷调查.结果 术后3个月,两组间裸眼远视力、中距离视力及近视力差异均无统计学意义(均为P ＞0.05).两组在明视及明视眩光状态时3c·d-1、6c·d-1、12 c·d-1、18 c·d-1空间频率下的对比敏感度差异均无统计学意义(均为P＞0.05);暗视及暗视眩光状态下时,T组在6c·d-1、12 c·d-1、18c·d-1空间频率下对比敏感度要优于A组,差异均有统计学意义(均为P ＜0.05),在低空间频率(3 c·d-1)下两组间差异均无统计学意义(均为P＞0.05).问卷调查示两组患者术后均极少出现影响正常生活的视觉干扰现象,术后满意度差异不明显.结论 AcrySofReSTOR +4 D阶梯渐进衍射型MIOL及Tecnis ZMB00+4 D全光学面衍射型MIOL均能为白内障患者提供满意的全程视力,尽管在暗视及暗视状态下眩光时的高空间频率下Tecnis ZMB00 MIOL对比敏感度要优于AcrySof ReSTOR MIOL,但对于绝大多数患者日常生活质量无明显影响.     

[In Press] Postoperative visual performance with a bifocal and trifocal diffractive intraocular lens during a 1-year follow-up

AIM: To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens (IOL) during a 12-month follow-up. METHODS: Prospective comparative study including 75 eyes of 46 patients (44-70 years) undergoing uneventful cataract surgery. Each patient was randomly assigned to one type of IOL, bifocal or trifocal (AT LISA 801 or AT LISA tri 839 MP, Carl Zeiss Meditec): 35 eyes in the bifocal group and 40 eyes in the trifocal group. Visual, refractive, and contrast sensitivity changes were evaluated in a 12-month follow-up. The binocular defocus curve was also measured at 12mo postoperatively. RESULTS: No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities (P≥0.276). Postoperative corrected near visual acuity was significantly better in the trifocal group during all follow-up (P≤0.004) as well as 6-month uncorrected near (P=0.008) (33 cm) and distance-corrected near visual acuities (P=0.016) (33/40 cm). Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group (P<0.001), which was consistent with differences among groups in binocular defocus curve. Differences among groups in contrast sensitivity were minimal, being only significant at 6 months for some low to medium spatial frequencies (P≤0.006). CONCLUSION: Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up, with a clear benefit of the trifocal IOL for the intermediate vision.     

Higher order aberration comparison between two aspherical intraocular lenses:MC6125AS and Akreos advanced optics

AIM: To compare higher order aberrations in two aspherical intraocular lenses (IOLs):Akreos advanced optics (AO) and Dr. Schmidt Microcrystalline 6125 aspheric anterior surface (MC6125AS) with each other.METHODS: Forty eyes of 39 patients underwent phacoemulsification and Akreos AO and MC6125AS were implanted in their eyes in a random manner. Three months post-operatively, higher order aberrations including spherical aberration, coma aberration, and total aberrations were measured and compared.RESULTS: The total aberration was 0.24±0.17 in eyes with Dr. Schmidt and 0.20±0.01 in eyes with Akreos AO (P=0.361). The mean of coma aberration was 0.17±0.21 and 0.09±0.86 in Dr. Schmidt and Akreos lenses, respectively (P=0.825). Total spherical aberration was almost the same in both groups (Mean:0.05, P=0.933). Best corrected visual acuity in Akreos AO (0.10±0.68) and Dr. Schmidt (0.09±0.67) did not differ significantly (P=0.700).CONCLUSION: There is no statistically significant difference in the higher order aberrations between these two aspherical lenses.     

Evaluation of visual quality of spherical and aspherical intraocular lenses by Optical Quality Analysis System

AIM: To evaluate the impact of spherical and aspherical intraocular lenses on the postoperative visual quality of age-related cataract patients using Optical Quality Analysis System (OQAS). METHODS: Seventy-four eyes with age-related cataracts were randomly divided into spherical and aspherical lens implantation groups. Best-corrected visual acuity (BCVA) was measured preoperatively, one day, one week, two weeks, one month and two months after surgery. A biometric systems analysis using the OQAS objective scattering index (OSI) was performed. RESULTS: There were no significant differences in visual acuity (P>0.05) before and after spherical and aspheric lens implantation. There was a negative linear correction between the OSI value and BCVA (r=-0.634, P=0.000), and positive corrections between the OSI value and the lens LOCUS III value of nucleus color (NC), nucleus opacity (NO), cortex (C) and posterior lens capsular (P) (r=0.704, P=0.000; r=0.514, P=0.000; r=0.276, P=0.020; r=0.417, P=0.000, respectively). OSI values of spherical vs aspherical lenses were 11.5±3.6 vs 11.8±3.4, 4.1±0.9 vs 3.3±0.8, 3.5±0.9 vs 2.7±0.7, 3.3±0.8 vs 2.6±0.7, 3.2±0.7 vs 2.5±0.8, and 3.2±0.8 vs 2.5±0.8 before and 1d, 1, 2wk, 1 and 2mo after surgery, respectively. All time points varied significantly (P<0.01) between the two groups. CONCLUSION: Aspherical IOLs does not significantly affect visual acuity compared with spherical IOLs. The OSI value, was significantly lower in the aspherical lens group compared with the spherical lens. This study shows that objective visual quality of aspheric IOLs is better than that of the spherical lens by means of OQAS biological measurement method.     

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。     

Aberration and contrast sensitivity comparison of aspherical and monofocal and multifocal intraocular lens eyes

BACKGROUND: Higher-order aberrations and contrast sensitivity were evaluated in patients who underwent phacoemulsification cataract extraction followed by implantation of aspherical, monofocal or multifocal intraocular lens (IOL) replacements. METHODS: In this comparative trial, 124 patients with an average age of 66.8+/-5.2 years and their 124 eyes were randomly divided into three surgical implantation groups to receive one of three types of IOLs in replacement of cataract lenses. The patients of group 1 were given an aspherical IOL Z9001 (AMO, Santa Ana, CA, USA) replacement, and group 2 was implanted a monofocal IOL SA60AT (Alcon, Fort Worth, TX, USA) and group 3 the multifocal IOL SA40N (AMO). Post-surgical best-corrected visual acuity, corneal aberrations, total ocular aberrations, pupil diameters, capsulorhexsis sizes and contrast sensitivity were measured and compared. RESULTS: There was no statistical difference for mean best-corrected visual acuity, pupil diameter, curvilinear capsulorhexis size and corneal aberration among the three groups. For the spherical aberration, fourth-order higher-order aberration and total ocular higher-order aberration, the SA40N group was higher than the SA60AT group and the SA60AT group was higher than the Z9001 group, and the differences between the three groups were statistically significant for these measurements. Contrast sensitivity was higher for the Z9001 group than the SA60AT group and the SA60AT group was higher than the SA40N group, and the difference was statistically significant in all the spatial frequencies of 3, 6, 12 and 18. CONCLUSIONS: Although the multifocal IOL can provide near vision, it can increase higher-order aberration and negatively influence contrast sensitivity. However, the aspherical IOL can reduce aberration and improve contrast sensitivity as compared with the monofocal IOL.     

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10μm were assigned to group A, those with 0.10 ≤corneal SA <0.20μm to Group B, and those with 0.20≤ corneal SA <0.35μm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.     

Visual and optical performance of eyes with different corneal spherical aberration implanted with aspheric intraocular lens

AIM: To compare the visual and optical performance of eyes with different corneal spherical aberration (SA) implanted with spherical aberration-free intraocular lens (IOLs). METHODS: Thirty-six patients with different corneal SA had phacoemulsification with implantation of spherical aberration-free IOLs. Patients were divided into 3 groups according to the value of preoperative corneal SA. Eyes with corneal SA <0.10μm were assigned to group A, those with 0.10 ≤corneal SA <0.20μm to Group B, and those with 0.20≤ corneal SA <0.35μm to Group C. Best-corrected visual acuity (BCVA), contrast sensitivity, corneal SA, total ocular aberrations, and depth of focus were recorded 3 months postoperatively. Distance-corrected near and intermediate visual acuity was studied to measure depth of focus. RESULTS: BCVA and contrast sensitivity were similar between groups. There were no significant differences in distance-corrected near or intermediate visual acuity. Corneal SA was similar before and 3 months after surgery in the 3 groups. With a 5.0mm pupil diameter, root mean square values for total ocular higher-order aberrations (HOAs) were lower in groups A and B than in group C. Total ocular SA was lower in group A than in groups B and C. SA was also lower in group B than in group C. Coma and trefoil were similar between the groups. CONCLUSION: Implantation of spherical aberration-free IOLs in eyes with different corneal SA results in similar visual performance at BCVA, contrast sensitivity and depth of focus.