Porovnn asferick se sferickou PCIOL

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Comparison of the Aspherical Tecnis Z9002 and the
Spherical Clariflex Silicone IOLs
Vinohrady Teaching Hospital, Prague, Czech
Republic
M.
Vokrojova MD, D. Sivekova MD,
L. Wagnerova MD Prof.
P. Kuchynka MD, PhD
The authors have no financial interest in the
presentation material
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PURPOSE, OBJECTIVE

• To evaluate quality of visual function after
  cataract surgery with implantation of spherical
  silicon intraocular lens to the one eye and
  aspherical silicon intraocular lens to the second
  eye of the same patient, and compare the results
  between these two different types of lenses.
• We conducted a prospective study,
• to compare patients visual functions.

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Endpoints included

• postoperative BCVA
• UNCVA
• efficacy
• wavefront - analysis
• contrast sensitivity under photopic condition
• subjective satisfaction of the patients

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MATERIALS, METHODS

• The group of the patients
• 40 eyes of 20 patients were randomly assigned
  and examined by masked examiner
• The mean age of the patients was 72,5 (59 - 84)
  years.
• 11 (55) women, 9 (45) men.
• Cataract condition was presented in all cases.
• Mean preoperative BCVA 0,4 (0,32 - 0,8)
• All surgeries were performed by an experienced
  surgeon using phacoemulsification with the
  Infinity Vision system (Alcon), topical
  anesthesia and standard surgical procedure.

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MATERIALS, METHODS
Tecnis Z9002
Clariflex

• 3-pieces, foldable, UV - blocking filter
• Biconvex optic diameter 6,0 mm
• Third generation silicone material
• polydimethyl - diphenylsiloxane
• OptiEdge design
• A - constant 118,0
• - Refractive index of 1.46

• TECNIS IOL was developed with help of
• wavefront technology.
• 3-pieces, foldable, UV-blocking filter
• Biconvex optic diameter 6,0 mm
• Third generation silicone material
• polydimethyl - diphenylsiloxane
• OptiEdge design
• A - constant 118,4
• - Aspherical anterior prolate surface
• - Refractive index of 1.46
• - Negative spherical aberration -0,27 µm

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MATERIALS, METHODS

• All patients were evaluated by a wavefront
  analyzer (Wavescan), contrast sensitivity
  (CSV-1000).
• - wavefront - analysis was performed
  monocularly with Wavescan (VISX) 3 months
  postoperatively.
• - contrast sensitivity was measured
  monocularly with the best distance correction
  with CSV 1000 instrument 3 months
  postoperatively.

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RESULTS
Aspherical IOL group (n20)
Non-aspherical IOL group (n20)
UNCVA 0,94 (0,63 - 1,0) BCVA 0,98 (0,8 -
1,0) Efficacy index post.UCVA/preop.BCVA
0,98/0,4
2,45
UNCVA 0,93 (0,63 - 1,0) BCVA 0,97 (0,8 -
1,0) Efficacy index post.UCVA/preop.BCVA
0,97/0,4
2,425
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RESULTS
Aspherical IOL
Non-aspherical IOL
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RESULTS

• Results of the wavefront
• analysis show that aspheric
• intraocular lens significantly
• reduces the occurrence of
• spherical aberration (plt 0,01)

Examination was performed min.1 month
postop. Min. pupil size was 5,5 mm
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RESULTS

• Results of the examination of contrast
  sensitivity show that aspheric intraocular lens
  are significantly better than spherical lenses
  (plt 0,05).

Aspherical IOL Non-asperical IOL

• 85 cd/m2

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Discussion

• The theoretical preclinical calculations studies
  suggest that spherical aberration of the eye
  after cataract surgery using the anterior prolate
  surface lenses can be modified.
• The anterior prolate surface of the Tecnis Z9002
  results in a negative spherical aberration of
  0,27 µm for 6,0 mm pupil to compensate positive
  spherical aberration of the cornea.
• The recent studies found that these modified
  lenses can improve contrast sensitivity under
  mesopic and photopic conditions.
• References
• 1. Packer M. Fine IH. Hoffman RS. Prospective
  randomized trial of an anterior surface modified
  prolate intraocular lens. J Refract Surg
  200218692-696
• 2. Packer M. Fine IH. Hoffman RS. Improved
  functional vision with modified prolate
  intraocular lens. J Cataract Refract Surg 2004
  30 986-992
• 3. Beiko GHH. Personalized correction of
  spherical aberration in catarct surgery. 2007
  33 1455-1460.

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CONCLUSSION

• Our results confirm that use of aspherical lenses
  can reduce occurrence of spherical aberration and
  can improve the visual performance of patients.
• The benefit of this lens can be appreciated only
  from patients with increased visual demands like
  car drivers, like our results suggest.