Spherical Aberration and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses: A Comparative Study

doi:10.1016/j.ajo.2007.12.023

American Journal of Ophthalmology

Volume 145, Issue 5, May 2008, Pages 827-833.e1

https://doi.org/10.1016/j.ajo.2007.12.023 Get rights and content

Purpose

To determine whether implantation of an intraocular lens (IOL) with a modified anterior aspheric surface results in reduced spherical aberration and improved contrast sensitivity after cataract surgery.

Design

Prospective, comparative, interventional case series.

Methods

In an intraindividual randomized prospective study of 25 patients with bilateral cataract, an IOL with a modified anterior surface (Tecnis Z9001; Advanced Medical Optics, Santa Ana, California, USA; group 1) was compared with biconvex lens with spherical surfaces (ClariFlex; Advanced Medical Optics; group 2). Ocular aberrations for a 5.0-mm pupil and 6.0-mm pupil were measured with Hartmann-Shack aberrometer. Quality of vision was measured by visual acuity and contrast sensitivity under mesopic and photopic conditions. All patients were followed up for three months.

Results

No statistically significant difference in postoperative uncorrected and best-corrected distance vision acuity after a follow-up of three months existed between the groups. Postoperative contrast sensitivity testing revealed significant differences between the groups under photopic and mesopic conditions. These differences reached statistical significance under photopic conditions at three spatial frequencies and under mesopic conditions at all spatial frequencies. When analyzing higher-order aberrations, the difference between the groups was statistically significant at the 5.00-mm and 6.00-mm pupil diameters, with the group 1 inducing less higher-order aberration and also less spherical aberration compared with group 2.

Conclusions

Results show the Tecnis Z9001 IOL with a modified anterior aspheric surface induced significantly less higher-order aberration and spherical aberration compared with the ClariFlex IOL. Contrast sensitivity revealed better values under photopic and mesopic conditions with the Tecnis Z9001 IOL.

Section snippets

Methods

This double-blind prospective, randomized study included patients with age-related cataract, no indication of existing ocular pathologic features, unsatisfactory correction with glasses, and less than 2.50 diopters (D) of topography cylinder. Patients were offered the opportunity to be part of a clinical trial in which they would be allocated to have cataract surgery with implantation of an aspherical or spherical IOL. Patients were randomized to receive a Tecnis Z9001 aspheric IOL in one eye

Results

Fifty eyes of 25 patients were included in the study. Eleven (44.0%) were men and 14 (56.0%) were women. The mean age of the patients was 65 years (range, 52 to 76 years; standard deviation [SD], ± 6.3 years). All patients were followed up for three months. All patients received the Tecnis Z9001 in one eye (group 1) and ClariFlex in the contralateral eye (group 2).

Before surgery, the mean logMAR UCDVA of group 1 was −0.54 (20/70; SD, ± 0.31), and that of group 2 was −0.60 (20/80; SD, ± 0.35),

Discussion

Cataract surgery and IOL implantation is becoming more of a refractive procedure, where results are measured not only by means of visual acuity, but also by quality of vision. Contrast sensitivity and wavefront analysis effectively represent the optical quality of vision.

These initial clinical results with the Tecnis Z9001 modified prolate IOL indicated significant improvement in some—but not all—spatial frequencies of contrast sensitivity as compared with the ClariFlex IOL under mesopic and

Dr Patrick F. Tzelikis completed his residency at São Geraldo Eye Hospital, Federal University of Minas Gerais (UFMG), Brazil, followed by a fellowship in cataract and refractive surgery at the same institution. From November 2003 to October 2004, he worked toward a subsequent fellowship in cornea, external disease, and refractive surgery at Wills Eye Hospital in Philadelphia, Pennsylvania. Dr Tzelikis is currently a member of the cataract and refractive service at Hospital Oftalmológico de

References (20)

A. Glasser et al.
Presbyopia and the optical changes in the human crystalline lens with age
Vision Res
(1998)
M. Packer et al.
Improved functional visual with a modified prolate intraocular lens
J Cataract Refract Surg
(2004)
U. Mester et al.
Impact of a modified optic design on visual function: clinical comparative study
J Cataract Refract Surg
(2003)
G. Muñoz et al.
Spherical aberration and contrast sensitivity after cataract surgery with the Tecnis Z9000 intraocular lens
J Cataract Refract Surg
(2006)
A. Denoyer et al.
Quality of vision after cataract surgery after Tecnis Z900 intraocular lens implantation: effect of contrast sensitivity and wavefront aberration improvements on the quality of daily vision
J Cataract Refract Surg
(2007)
R. Bellucci et al.
Visual acuity and contrast sensitivity comparison between Tecnis and AcrySof SA60AT intraocular lenses: a multicenter randomized study
J Cataract Refract Surg
(2005)
T. Kasper et al.
Intraindividual comparison of higher-order aberrations after implantation of aspherical and spherical intraocular lenses as a function of pupil diameter
J Cataract Refract Surg
(2006)
G.B. Arden
The importance of measuring contrast sensitivity in cases of visual disturbance
Br J Ophthalmol
(1978)
D.B. Elliott
Evaluating visual function in cataract
Optom Vis Sci
(1993)
G.S. Rubin et al.
Comparison of acuity, contrast sensitivity, and disability glare before and after cataract surgery
Arch Ophthalmol
(1993)

There are more references available in the full text version of this article.

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Prospective observational comparative study.
This study included patients who had cataract surgery with implantation of a spherical monofocal IOL. The patients were divided into three groups according to the IOL power. Group 1: +20 diopters (D) to +23 D; Group 2: less than +10 D; and Group 3: +29 D or more. Assessment after 3 months included: uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, contrast sensitivity function test (Ginsburg), corneal aberrometry, and total ocular aberrometry with a pyramidal wavefront sensor aberrometer (Osiris) for 4.0 mm, 4.5 mm, and 5.0 mm pupil diameters.
The study comprised 88 eyes of 56 patients. There were no differences between all groups in terms of refractive error, corneal aberrometry, or total ocular higher-order aberrations at any analyzed pupil diameter. The ocular spherical aberration (SA) was not significantly different between groups with a 4.0 mm pupil. The SA was significantly lower in Group 2 when compared with Group 1 and Group 3 for both 4.5 mm (P = .01 and P = .001, respectively) and 5.0 mm (P = .002 and P = .002, respectively). There was no significant difference in SA between Group 1 (+20 D to 23 D) and Group 3 (≥+29 D) at any analyzed pupil diameter. Higher SA did not correlate to lower contrast sensitivity.
Despite the theoretical evidence, only a negligible amount of clinically insignificant aberrations were induced by high-powered positive IOLs. Low-powered IOLs did not induce significant levels of SAs.
Analysis of corneal higher-order aberrations in cataract patients with high myopia
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To evaluate the differences in corneal higher-order aberrations (HOAs) between cataract patients with high axial myopia and normal cataract patients, and to identify the associated factors.
Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China.
Retrospective case series.
Corneal aberrations and axial lengths (ALs) were measured using a rotating Scheimpflug camera (Pentacam) and partial coherence interferometry (IOLMaster) in the high myopia group and the control group.
The study comprised 287 patients (520 eyes). There were 194 eyes in the high myopia group and 326 eyes in the control group. The 5 anterior corneal aberrations—vertical coma, vertical trefoil, horizontal coma, oblique trefoil, and primary spherical aberration—in the high myopia group were 0.07 μm ± 0.38 (SD), −0.11 ± 0.23 μm, 0.07 ± 0.28 μm, −0.02 ± 0.18 μm, and 0.39 ± 0.19 μm, respectively. No negative primary spherical aberrations of the total or anterior corneal surface were found in the high myopia group. Differences between the 2 groups were found in terms of central corneal thickness, astigmatism, primary spherical aberration, vertical coma, and oblique trefoil; however, these differences were not consistent between different age subgroups. Higher-order aberrations were correlated with age. Posterior corneal vertical coma was correlated with AL (Pearson correlation = −0.188, P = .047).
Negative primary spherical aberrations of the anterior or total corneal surface were not found in the high myopia group. Age showed a strong relationship with HOAs. For cataract patients with high myopia, aspheric intraocular lens implantation is recommended.
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Citation Excerpt :
In contrast and when multifocal intraocular lenses are considered, it was shown that these lenses increases the amount of spherical aberration and lead to an reduction in the sensitivity to contrast [23]. Additionally, it is known that reducing the spherical aberration due to the use of monofocal aspherical designs increases the sensitivity to contrast, when compared to the contrast sensitivity with spherical intraocular lenses [24,25]. Inferentially, it cannot be concluded if the observed differences between the Center-Near and Center-Distance design of the soft multifocal contact lenses are caused by their influences on the higher aberrations of the eye.
The study investigated the effect of the design of multifocal contact lenses on the sensitivity to contrast and disability glare.
Contrast sensitivity was measured in 16 young adults (mean age: 25.5 ± 2.5 years) at a distance of 2 m under two conditions: no-glare and glare. Two designs (Center Near and Center Distance) of the Biofinity soft contact lens were used to simulate correction for presbyopes, while a correction with single vision trial lenses and contact lenses acted as controls.
The design of the used multifocal contact lenses had a significant influence on the log area under the curve of the contrast sensitivity function (AUC-CSF). Compared to the spectacle lens correction, the AUC-CSF was significantly reduced, in case CS was measured with the Center Near design lens, under the no-glare (p < 0.001) and the glare condition (p: p < 0.001). In case of the Center Distance design contact lens, the AUC-CSF was significantly smaller in case CS was tested under glare (p = 0.001). Disability glare (DG) was depending on the spatial frequency and the design of the multifocal lens, while the Center Distance design produced higher amounts of DG (p < 0.001), compared to the other used corrections.
The optical design of a multifocal contact lenses has a significant impact on the contrast sensitivity as well as the disability glare. In order to dispense the best correction in terms of contact lenses, the sensitivity to contrast under no-glare and glare conditions should be tested a medium spatial frequencies.
Visual Performance of a Quadrifocal (Trifocal) Intraocular Lens Following Removal of the Crystalline Lens
2017, American Journal of Ophthalmology
To evaluate visual performance after implantation of a quadrifocal intraocular lens (IOL).
Setting: Department of Ophthalmology, Goethe University, Frankfurt, Germany. Study Population: Twenty-seven patients (54 eyes) received bilateral implantation of the PanOptix IOL (AcrySof IQ PanOptixTM; Alcon Research, Fort Worth, Texas, USA) pre-enrollment. Exclusion criteria were previous ocular surgeries, corneal astigmatism of >1.5 diopter (D), ocular pathologies, or corneal abnormalities. Intervention or Observational Procedure(s): Postoperative examination at 3 months including manifest refraction; uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) in 4 m, 80 cm, 60 cm, and 40 cm slit-lamp examination; defocus testing; contrast sensitivity (CS) under photopic and mesopic conditions; and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence was performed. Main Outcome Measure(s): At 3 months postoperatively, UCVA and DCVA in 4 m, 80 cm, 60 cm, and 40 cm (logMAR), defocus curves, CS, and quality-of-vision questionnaire results.
Mean spherical equivalent was −0.04 ± 0.321 D 3 months postoperatively. Binocular UCVA at distance, intermediate (80 cm, 60 cm), and near was 0.00 ± 0.094 logMAR, 0.09 ± 0.107 logMAR, 0.00 ± 0.111 logMAR, and 0.01 ± 0.087 logMAR, respectively. Binocular defocus curve showed peaks with best visual acuity (VA) at 0.00 D (−0.07 logMAR) and −2.00 D (−0.02 logMAR).
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This review was conducted to compare the physical effect of aspheric IOL implantation on wavefront properties with that of spherical IOL implantation. The peer-reviewed literature was systematically searched in Medline, Embase, Web of Science, Biosis, and the Cochrane Library according to the Cochrane Collaboration method. Inclusion criteria were randomized controlled trials comparing the use of aspheric versus spherical monofocal IOL implantation that assessed visual acuity, contrast sensitivity, or quality of vision. A secondary outcome was ocular wavefront analysis; spherical aberration, higher-order aberrations (HOAs), coma, and trefoil were evaluated. Effects were calculated as standardized mean differences (Hedges g) and were pooled using random-effect models. Thirty-four of 43 studies provided data for wavefront analysis. Aspheric monofocal IOL implantation resulted in less ocular spherical aberration and fewer ocular HOAs than spherical IOLs. This might explain the better contrast sensitivity in patients with aspheric IOLs.
No author has a financial or proprietary interest in any material or method mentioned.

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Original articleSpherical Aberration and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses: A Comparative Study

Purpose

Design

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Vision Res

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

J Cataract Refract Surg

The importance of measuring contrast sensitivity in cases of visual disturbance

Br J Ophthalmol

Evaluating visual function in cataract

Optom Vis Sci

Comparison of acuity, contrast sensitivity, and disability glare before and after cataract surgery

Arch Ophthalmol

Original article
Spherical Aberration and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses: A Comparative Study