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.     

非球面人工晶状体术后视功能评估

目的 评估植入人工晶状体前表面非球面修饰的TecnisZ9003(AMO)术后视功能是否优于传统的球面人工晶状体(Acrosof Natural,Alcon).方法 随机选择8例白内障手术患者,1只眼植入Z9003 IOL,另眼植入Acrysof Natural SN6OATIOL.术后1周和1月,行对比敏感度检查、眩光检查和像差仪检查,分别评价术后视功能.结果 两组间平均术前和术后球镜、柱镜度及最佳矫正视力无统计学意义.对比敏感度(明亮光下)术后1周没有明显不同,术后1月植入TecnisZ9003 IOL眼在所有空间分辨率下均优于对侧眼,尤其在3,6cpd下差异有统计学意义.眩光检查两组间没有差别.像差仪检查显示术后1周、1月植入TecnisZ9003IOL眼的球差明显小于对侧眼.结论 临床结果证实白内障术后的球差可以通过植入非球面修饰的人工晶状体所消除.这样可以明显提高对比敏感度和功能视力.     

两种不同非球面人工晶状体眼像差与视觉质量的研究

目的 比较植入两种不同非球面人工晶状体(intraocular lens,IOL)的老年性白内障患者术后的视觉质量以及像差与瞳孔变化的关系.方法 取66例单纯性老年性白内障患者66只眼,33只眼随机植入眼力健公司的TECNISZA9003,33只眼植入博士伦公司的ADAPT-AO,术后3个月观察患者的裸眼视力,最佳矫正视力(BCVA),3mm及5mm瞳孔下的总4阶球差,总彗差,总高阶像差,内眼4阶球差,及角膜的4阶球差,测量患者在白天,白天加眩光,夜间,夜间加眩光四种背景下的对比敏感度(CS).对数据进行两组独立样本非参数检验.结果 瞳孔由3mm到5mm,两组角膜球差,总彗差,总高阶像差显著增大,差异有统计学意义;TECNIS组总球差与ADAPT-AO组内眼球差随瞳孔增大无显著变化,差异无统计学意义.两种瞳孔直径下ADAPT-AO组总高阶与总球差大于TECNIS组,差异有统计学意义;两种瞳孔直径下两组角膜球差与总彗差差异无统计学意义.在白天,白天加眩光,夜间,夜间加眩光四种背景模式下,各空间频率CS差异均无统计学意义.结论 与ADAPT-AO非球面IOL眼相比,ZA9003非球面IOL在大瞳孔和小瞳孔下都能降低全眼球差与高阶像差,但两组对比敏感度差异无统计学意义.     

双眼超声乳化白内障吸除术后植入不同人工晶状体对比敏感度及像差改变的对比研究

目的探讨双眼超声乳化白内障吸除术后植入不同人工晶状体（IOL）后对比敏感度及像差的改变。方法选择我院2005年4至8月年龄相关性白内障患者63例,在知情同意的前提下,双眼行超声乳化白内障摘除术后,一只眼植入SA60AT型IOL,另一只眼植入TecnisZ9001型IOL。术后1和3个月分别进行电脑及综合验光仪验光及最佳矫正视力、眩光和无眩光条件下的对比敏感度、角膜像差、4和6mm瞳孔直径时眼的总体像差检测。结果术后1和3个月,所有患者双眼最佳矫正视力的差异均无统计学意义（P〉0．05）;两组角膜的球面像差、彗差及总像差均方根的差异均无统计学意义（P〉0．05）。术后1和3个月植入29001型IOL眼的对比敏感度在空间频率3、6、12、18c／d时无眩光、有眩光条件下均大于植入SA60AT型IOL的眼（P〈0．05）。术后1和3个月,瞳孔直径4和6mm时比较Zemike多项式C12、RMS4、RMSh,植入Z9001型IOL的眼均小于植入SA60AT型IOL的眼（P〈0．05）。结论TecnisZ9001较SA60AT型IOL可以改善眼的高阶像差特别是球面像差,提高功能视力。     

非球面人工晶状体植入眼的视觉质量分析

目的 观察非球面人工晶状体(IOL)、球面IOL植入眼与正常中青年人眼的波前像差和对比敏感度差异.方法 46例(49只眼)老年性白内障患者随机分成两组,分别植入非球面IOL Acrysof IQ(SN60WF)和球面IOL Acrysof Nature(SN60AT).随机选择同期正常中青年人(年龄20~40岁)作为对照组.分别对术后3月的患者和对照组进行最佳矫正视力、像差和对比敏感度检查.结果 IQ组的球差显著小于Natural组(P ＜0.05),而和正常中青年组比较无统计学意义(P ＞0.05);两IOL组的高阶像差和慧差均显著大于正常中青年组(P ＜0.05).非眩光状态下,IQ组在低频时(6.3degrees)的对比敏感度显著高于Natural组(P ＜0.05),和正常中青年组比较无统计学意义(P ＞0.05);眩光状态下,IQ组在低频时(6.3和4.0degrees)的对比敏感度显著高于Natural组(P ＜0.05),两IOL组在所有视角下的对比敏感度均显著低于正常中青年组(P ＜0.05).结论 非球面IOL植入能使白内障患者术后眼内球差明显减小,非眩光状态下低频时的对比敏感度明显提高,更接近正常中青年人眼水平,具有比球面IOL更佳的视觉质量.     

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。     

白内障术后植入不同人工晶状体视觉质量的对比分析

目的 对比分析白内障手术植入蓝光滤过晶状体(SA60AT)与非球面晶状体(TecnisZg001)术后视觉质量的变化.方法 选择我院2007年5月至2008年2月年龄相关性白内障患者72例.随机分成两组,均行超声乳化吸除联合人工晶状体植入术.对照组(36例)植入蓝光滤过晶状体SA60AT,实验组(36例)植入非球面晶状体TecnisZ9001.于术后1个月和3个月分别进行视力、对比敏感度和波前像差的检查.结果 视力:术后1个月和3个月,两组术后术眼最佳矫正视力差异无统计学意义(P＞0.05).对比敏感度:术后1个月,在无眩光和眩光环境下,对比敏感度6c/d、12c/d、18c/d,对照组均小于实验组,差异有显著性(P＜0.05),术后3个月在无眩光和眩光环境下,对比敏感度6c/d、12c/d、18c/d,对照组均小于实验组,差异有显著性(P＜0.05).波前像差:术后1个月、3个月,两组在瞳孔直径≥5 mm时的三阶彗差、四阶球差、高阶像差的均方根(RMS值)比较,实验组均低于对照组,两组有统计学意义(P＜0.05).结论 非球面晶状体与蓝光滤过晶状体在同时提高患者视力的同时,可以更好的改善术眼对比敏感度和高级像差,提高术眼视觉质量.     

白内障术后不同全眼球差对视觉质量的影响

目的：观察不同角膜球差患者植入相同非球面IOL后的视力及对比敏感度,探讨白内障术后不同全眼球差对视觉质量的影响。
　　方法：前瞻性病例系列研究。收集在我院就诊拟行手术治疗的年龄相关性白内障患者39例46眼。依据术前角膜球差将患眼分为3组。角膜球差≤0.2μm者为 A 组,~0.3μm者为B组,>0.3μm者为C组。所有患者均行白内障超声乳化吸除联合 ArcySof IQ 非球面 IOL 植入术。术后3mo 观察患者的裸眼视力( uncorrected visual acuity, UCVA)、最佳矫正视力( best -corrected visual acuity, BCVA)、对比敏感度及6.0mm瞳孔直径下的全眼高阶像差。采用方差分析对获得的数据进行统计学分析。
　　结果：术后3mo,3组患者的裸眼视力、最佳矫正视力差异无统计学意义( P=0.287,0.115)。对比敏感度在不同亮度背景下、不同空间频率差异均无统计学意义(P>0.05)。术后6.0mm瞳孔直径全眼总高阶像差均方根A组与B组小于C组,差异有统计学意义(P=0.000)。3组间球差差异有统计学意义(P=0.000),彗差及三叶草差异无统计学意义( P=0.788,0.590)。
　　结论：不同角膜球差患者植入相同非球面IOL后的视力及对比敏感度相似。白内障术后全眼球差的少量差异对视觉质量无明显影响。     

零像差设计的非球面人工晶状体的临床应用研究

目的 比较零像差设计的非球面人工晶状体(IOL)与传统球面IOL对超声乳化自内障吸除联合IOL植入术后患者眼球差、视觉功能以及表观调节力的影响.方法 采用前瞻性随机对照设计,将130例(132只眼)拟行超声乳化白内障吸除联合IOL植入术的年龄相关性白内障患者按随机数字表法分为2组,分别植入零像差设计的非球面IOL(试验组)和传统球面IOL(对照组).术后检测IOL眼的球差、矫正远视力、矫正远视力后的近视力、对比敏感度、眩光敏感度及表观调节力;随访时间为3个月.采用χ~2检验和独立样本t检验分别对计数资料和计量资料进行统计学分析.结果 术后3个月,瞳孔直径5 mm情况下IOL眼的球差试验组为(0.141±0.070)μm,对照组为(0.210±0.108)μm,差异有统计学意义(t=4.365,P=0.000).2.5°视角的对比敏感度试验组为30.62±12.50,对照组为25.92±7.36,差异有统计学意义(t=2.606,P:0.010);眩光敏感度在4.0°、2.5°及1.6°视角上分别为31.25±8.65、26.35±8.72和12.35±4.01,显著高于对照组在相应视角上的26.70±7.98(t=3.116,P=0.002)、22.43±7.35(t=2.772,P=0.006)及9.82±4.12(t=3.553,P=0.001);两组的矫正远视力、矫正远视力后近视力、表观调节力比较,差异均无统计学意义.结论 与传统球面IOL比较,零像差的非球面IOL Akreos AO可以显著减少IOL眼的总球差,改善白内障患者术后的视觉质量,且对患者术后的表观调节力无明显影响.     

黄色非球面人工晶状体植入术后视觉质量的临床分析

目的 观察老年性白内障患者植入黄色非球面人工晶状体AcrySof IQ术后对比敏感度和眩光敏感度.方法 前瞻性临床对照研究.56例(56只眼)老年性白内障患者,随机分为三组,分别植入非球面人工晶状体AerySof IQ(SN60wF)及球面人工晶状体Acrysof Natural(SN60AT)、Acrysof (SA60AT).术后2月行最佳矫正视力、像差及对比敏感度检查.结果 三组患者术后最佳矫正视力≥20/30.IQ组与球面晶状体组比较,球差均显著性减少(P<0.05),高阶像差及彗差无统计学意义(P0.05).在非眩光状态下,低频时IQ组的对比敏感度(10g值)显著高于球面晶状体组(P<0.05),中频2.5deg时IQ组的对比敏感度显著高于SA60AT组(P<0.05).在眩光状态下,低频时IQ组的对比敏感度也显著高于球面晶状体组(SN60AT组:P<0.01,SA60AT组:6.3degrees P<0.01,4.0degrees P<0.05).结论 非球面人工晶状体可以减少球面像差,提高低频尤其是眩光状态下的对比敏感度从而获得更好的视觉质量.滤蓝光晶状体与普通晶状体比较对比敏感度差异无统计学意义,不能明显改善视功能.     

Visual outcome and optical quality after bilateral implantation of aspheric diffractive multifocal, aspheric monofocal and spherical monofocal intraocular lenses:a prospective comparison

AIM:To evaluate the visual function after bilateral implantation of aspheric diffractive multifocal Tecnis ZMA00, aspheric monofocal ZA9003 versus spherical monofocal Akreos Adapt intraocular lenses (IOLs).METHODS:Tecnis ZMA00, Tecnis ZA9003 or Akreos Adapt IOLs were bilaterally implanted in 180 eyes from 90 patients. The following parameters were assessed 3 months postoperatively:monocular and binocular uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) for distance, intermediate and near, spherical aberration (SA), contrast and glare sensitivity, near point refractive power, uncorrected and best-corrected near stereoscopic acuity (NSA). Patient satisfaction was assessed by a questionnaire.RESULTS:Three months postoperatively, the monocular and binocular UCVA and DCVA at near of Tecnis ZMA00 were significantly better than other two groups. The mean SA for 5.0mm optical zone in Tecnis ZMA00 and Tecnis ZA9003 was significantly lower than that in Akreos Adapt. Mean contrast sensitivity and glare sensitivity were better for Tecnis ZA9003 group than for other two groups. Patients with Tecnis ZMA00 had higher monocular and binocular near point refractive power and uncorrected NSA than monofocal groups. The patients in Tecnis ZMA00 had higher mean values for halo compared with other two groups.CONCLUSION:Tecnis ZMA00 provided better near VA and uncorrected NSA and higher near point refractive power than monofocal IOLs and patients were spectacle independent. The IOLs with Tecnis aspheric design improved contrast and glare sensitivity. Patients with Tecnis ZMA00 reported more disturbances on visual phenomena of halo.     

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.     

白内障手术前后角膜球面像差的比较及非球面人工晶状体评估

目的研究白内障手术前后角膜球面像差的变化,并评估非球面人工晶状体（IOL）术后的临床表现。方法90例（120只眼）白内障患者手术前后分别测量角膜球差;植入非球面IOL者84只眼,植入球面IOL者36只眼,比较两组术后的裸眼视力、最佳矫正视力及明暗条件下对比敏感度。结果术前平均角膜球差为（0．498±0．189）um,术后为（0．491±0．135）um,（P〉0．05）;植入非球面IOL组在6、12、18cpd空间频率的对比敏感度优于球面IOL组（P〈0．01）,且裸眼视力略优于后者。结论植入非球面IOL可以获得更好的视功能,且白内障手术不改变角膜球差。     

Intraindividual comparison of higher-order aberrations after implantation of aspherical and spherical intraocular lenses as a function of pupil diameter

PURPOSE: To compare intraindividual higher-order wavefront aberrations after implantation of aspherical and spherical intraocular lenses (IOLs) as function of pupil diameter. SETTING: Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. METHODS: In this prospective study, wavefront measurements of 21 patients after implantation of a spherical IOL (AMO AR40e) in 1 eye and an aspherical IOL (AMO Tecnis) in the contralateral eye were analyzed. Third-, 4th-, 5th-, total higher-order aberration (HOA) root-mean-square (RMS), and primary spherical aberration (Z(4)(0)) were compared at different virtual pupil diameters of 3 to 6 mm. RESULTS: For both IOLs and each higher order analyzed, values increased with increasing pupil diameter. Fourth-order RMS and Z(4)(0) in the aspherical IOL group were significantly lower than with the spherical IOL at all analyzed pupil diameters. The total HOA RMS of the aspherical IOL was significantly lower than the spherical IOL only at 6 mm pupil diameter. For 3rd- and 5th-order RMS, no significant difference was found between the tested IOLs at any pupil diameter. CONCLUSION: In comparison to a spherical IOL, the aspherical Tecnis IOL reduced Z(4)(0) and 4th-order RMS significantly for pupil diameters of 3 to 6 mm, whereas total HOA RMS was only significantly reduced for a pupil diameter of 6 mm.     

Wavefront analysis and contrast sensitivity of aspheric and spherical intraocular lenses: a randomized prospective study

PURPOSE: To compare visual performance, total and high order wavefront aberrations (coma, spherical aberration, and other terms), and contrast sensitivity in 120 eyes implanted with one monofocal aspheric intraocular lens (IOL) and two spherical IOLs. DESIGN: Randomized prospective study. METHODS: Sixty patients were randomized to receive three IOL types: Alcon AcrySofIQ (40 eyes), AcrySofNatural (40 eyes), and advanced medical optic (AMO)Sensar (40 eyes). Complete ophthalmologic examination including uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BSCVA), corneal topography, and wavefront analysis were performed preoperatively, 30 days, and 90 days postoperatively. Pelli-Robson chart test and functional acuity contrast testing (FACT-Optec6500) were performed approximately 50 days after surgery. Statistical analyses were performed using analysis chi(2), analysis of variance (ANOVA), and multiple comparisons Tukey test. RESULTS: After 90 days, all eyes had postoperative BSCVA > or =20/32. The AcrySofIQ IOL showed statistically significant less induction of spherical aberration (P < .001) when compared with the AMOSensar and the AcrySofNatural IOLs. The AMOSensar presented significantly less spherical aberration then the AcrySofNatural (P < .05). The AcrySofIQ also had lower values of total and high-order aberration (HOA) (P < .05) when compared with the AMOSensar and the AcrySofNatural. The mean values of trefoil 9, coma, and HOA root mean square (RMS) decreased between one and three months (P < .001, P < .001, P = .023, P < .001, respectively) in all groups. Mean Pelli-Robson contrast sensitivity values in photopic condition were similar between the groups. The AcrySofIQ showed better results in 3cpd spatial frequency in mesopic condition using FACT-Optec 6500 (P = .008), although there were no statistical differences in photopic and mesopic with glare conditions.     

High order aberration and straylight evaluation after cataract surgery with implantation of an aspheric, aberration correcting monofocal intraocular lens

AIM:To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting, monofocal intraocular lens (IOL).METHODS:Twenty-one patients (34 eyes) aged 50 to 83y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL (Tecnis ZCB00, Abbott Medical Optics). Three months after surgery they were examined for uncorrected (UDVA) and corrected distance visual acuity (CDVA), contrast sensitivity (CS) under photopic and mesopic conditions with and without glare source, ocular high order aberrations (HOA, Zywave II) and retinal straylight (C-Quant).RESULTS:Postoperatively, patients achieved a postoperative CDVA of 0.0 logMAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27 (primary coma components) and -0.04±0.16 (spherical aberration term). Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed (P≥0.28).CONCLUSION:The implantation of an aspherical aberration correcting monofocal IOL after cataract surgery resulted in very low residual higher order aberration (HOA) and normal straylight.     

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.     

Spherical aberration and contrast sensitivity after cataract surgery with the Tecnis Z9000 intraocular lens

PURPOSE: To determine whether implantation of an intraocular lens (IOL) with a modified prolate anterior surface (Tecnis Z9000, AMO) results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. SETTING: Hospital NISA Virgen del Consuelo, Valencia, Spain. METHODS: In an intraindividual randomized prospective study of 30 patients with bilateral cataract, the Tecnis Z9000 IOL was compared with 2 IOLs with spherical surfaces, the AR40e (AMO) and the Stabibag (Ioltech). Ocular aberrations for a 4.0 mm pupil and 6.0 mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured by visual acuity and contrast sensitivity under mesopic and photopic conditions. RESULTS: Eyes with the Tecnis Z9000 IOL had significantly less spherical aberration and a greater Strehl ratio after surgery. Significant reduction in coma aberration was also found in some cases. Refraction, visual acuity, and contrast sensitivity were not significantly different between the 3 IOL groups. CONCLUSION: A significant reduction in spherical aberration after Tecnis Z9000 IOL implantation was achieved, but visual acuity and contrast sensitivity were not affected by the aspheric silicone IOL compared to spherical acrylic IOLs.