title: Effect of total higher-order aberrations on accommodation in pseudophakic eyes.
abstract: OBJECTIVE
  To analyze the effect of total higher-order aberrations (HOAs) on the range of accommodation in pseudophakic eyes and the size of near-vision optotypes.
  
  
  METHODS
  Department of Ophthalmology, Nara Medical University, Nara, Japan.
  
  
  METHODS
  The study comprised 30 patients (44 eyes) who were diagnosed with cataract at Nara University of Medical Science Hospital and Municipal Oyodo Hospital. Inclusion criteria included no other eye disorder and a best corrected distance acuity of 20/20 or better 1 month after cataract surgery. All patients had small-incision phacoemulsification followed by in-the-bag implantation of a monofocal intraocular lens (SA60AT, Alcon). All incisions were self-sealing. Accommodation in pseudophakic eyes was measured by the lens-loading method in an examination room under constant illumination. Ocular HOAs were measured using the KR-9000PW Hartmann-Shack wavefront analyzer (Topcon).
  
  
  RESULTS
  The mean patient age was 75.8 years +/- 5.4 (SD) (range 64 to 83 years). The Pearson correlation coefficient (r) showed a significant positive correlation between the range of accommodation and Z7 (vertical coma) for a 4.0 mm pupil using the 1.0 near-vision optotype. There was a significant negative correlation between the range of accommodation and Z12 (spherical aberration) for a 4.0 mm pupil using the 1.0 near-vision optotype (r = .311, P = .040 for Z7;r = -.365, P = .015 for Z12). No other parameter was significantly correlated with the range of accommodation.
  
  
  CONCLUSIONS
  Measurement of accommodation in pseudophakic eyes by the lens-loading method using the 1.0 near-vision optotype showed that eyes with larger vertical coma aberrations achieved a larger range of accommodation. In contrast, eyes with larger spherical aberrations had smaller amounts of accommodation. The size of the near-vision optotype may affect accommodation analysis in pseudophakic eyes.
authors.affiliation: Department of Ophthalmology, Nara Medical University, Kashihara City, Nara, Japan. ntomo24@r7.dion.ne.jp
authors.forename: Tomo
authors.initials: T
authors.lastname: Nishi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nawa
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ueda
authors.forename: Kouzou
authors.initials: K
authors.lastname: Masuda
authors.forename: Futoshi
authors.initials: F
authors.lastname: Taketani
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hara
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D019654:Lens Implantation, Intraocular; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D018918:Phacoemulsification; D019591:Pseudophakia / Q000503:physiopathology*; D012030:Refractive Errors / Q000503:physiopathology*; D014792:Visual Acuity