Corneal optical aberrations and retinal image quality in patients in whom monofocal intraocular lenses were implanted.
OBJECTIVE
To compare retinal image quality and optical corneal aberrations in patients in whom monofocal polymethyl methacrylate intraocular lenses (IOLs) were implanted with those in healthy subjects of a similar older age (60-70 years old) and to use the results to suggest improved optical designs of IOLs to maximize retinal image quality.


METHODS
A double-pass apparatus was used to measure retinal image quality for 3-, 4-, and 6-mm pupil diameters. Corneal aberrations for a 4-mm pupil were calculated by a ray-tracing technique from the elevations provided by corneal topography. Two groups of 20 subjects of a similar older age were studied: in one group, polymethyl methacrylate monofocal IOLs were implanted; and in a second group, healthy subjects were used as a reference.


RESULTS
The average retinal image quality was similar in older healthy patients and in patients in whom IOLs were implanted, with both groups having a significantly worse image quality than healthy younger subjects (aged 20-30 years). Both groups were more tolerant to defocus than younger subjects.


CONCLUSIONS
The average retinal image quality of patients in whom IOLs were implanted was worse than that of healthy younger subjects despite the good optical quality of isolated IOLs. This apparent paradox can be understood by the nature of the aberration coupling in the eyes that undergo implantation. The ideal substitute for the natural lens is not an IOL with the best-isolated optical performance, but rather one designed to compensate for the aberrations of the cornea-a design somehow inspired by the crystalline lens of younger subjects.
Guirao
Antonio
A
Laboratorio de Optica, Departamento de Física, Universidad de Murcia, Campus de Espinardo (Edificio C), 30071 Murcia, Spain. pablo@um.es
Redondo
Manuel
M
Geraghty
Edward
E
Piers
Patricia
P
Norrby
Sverker
S
Artal
Pablo
P
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D015350:Contrast Sensitivity / Q000502:physiology; D003315:Cornea / Q000502:physiology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D055095:Optics and Photonics; D019904:Polymethyl Methacrylate; D012160:Retina / Q000502:physiology*; D014785:Vision, Ocular / Q000502:physiology*
D019904:Polymethyl Methacrylate