Spherical Aberration Post Bilateral Implantation of Two Prevalent Aspheric IOLs

1
Spherical Aberration Post Bilateral Implantation
of Two Prevalent Aspheric IOLs

• DR. ROBERT A. KAUFER, MD
• MARTINEZ, BUENOS AIRES
• ARGENTINA
• robert_at_kaufer.com
• This research funded by Alcon
  Laboratories.

2
Purpose

• 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.

3
Methods

• Final enrollment 37 bilateral patients
• 18 SN60WF
• 19 Z9000
• Healthy eyes
• Postop exam 3 months after surgery
• Spherical Aberration (SA)
• Trace aberrometer/topographer (Tracey
  Technologies)
• Non-dilated 4.5mm scan
• VA
• Contrast

4
IOL Specifications
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 µm
Residual SA by Design 0.1 µm 0.0 µm
5
Percent Distribution of Postop Spherical
Aberration (µm)
Lens had no apparent effect on amount of
postoperative SA
72
68
n74 eyes
6
Results Analysis

• 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
• lt0.1µm postop SA OU
• gt0.1µm postop SA OU
• Mixed (one eye lt 0.1 µm one eye gt 0.1 µm)

7
Binocular BCVA with Three Postop SA Groups
20/16
Snellen
20/20
lt0.1µm
gt0.1µm
Mixed
(n22)
(n9)
(n6)
8
12.5 Low Contrast Acuity with Three Postop SA
Groups
20/20
20/25
20/30
Snellen
20/40
20/50
20/63
20/80
(n22)
(n9)
(n6)
9
Photopic Contrast Sensitivity with Three Postop
SA Groups
(n22)
(n9)
(n6)
10
Mesopic Contrast Sensitivity with Three Postop SA
Groups
11
Mesopic with Glare Contrast Sensitivity with
Three Postop SA Groups
12
Conclusions

• A slight positive postoperative SA (gt0.1 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.