Optical quality of the eye after lens replacement with a pseudoaccommodating intraocular lens.
OBJECTIVE
To examine the optical quality of healthy presbyopic eyes before and after implantation of the pseudoaccommodating AcrySof ReSTOR Natural intraocular lens (IOL) (Alcon Laboratories) by measuring visual acuity and wavefront aberrations.


METHODS
University of Valencia, Fernández-Vega Ophthalmological Institute, Valencia, Spain.


METHODS
Monocular refraction and photopic distance (6 m) and near (0.33 m) visual acuities were determined before and after clear lens extraction with bilateral AcrySof ReSTOR Natural IOL implantation in 30 hyperopic eyes (+0.50 to +4.00 diopters [D]) of presbyopic patients with low astigmatism (< or = 1.00 D). Postsurgical binocular visual acuity was measured over a range of effective distances. Wavefront aberrations were measured before and after surgery. Aberrations for 2 pupil diameters (3.0 mm and 5.0 mm) were decomposed using Zernike polynomials; total, defocus, astigmatism spherical, and coma aberration terms were studied separately. Postimplantation results were compared with preoperative values.


RESULTS
Safety and efficacy indices for distance vision were 1.01 and 0.96, respectively. At near, they improved to 1.07 and 1.06, respectively. Vision at intermediate distances was noticeably poorer. Total, defocus, and spherical aberrations changed after IOL implantation with both pupil diameters (P<.01). Total and defocus aberrations were significantly reduced postoperatively. Spherical aberration coefficients changed to negative and less positive values for a 3.0 mm and a 5.0 mm pupil, respectively.


CONCLUSIONS
Implantation of the pseudoaccommodating IOL in healthy eyes yielded uncorrected levels of high-contrast, distance, and near acuities comparable to preoperative best corrected values. Higher-order aberration levels appeared to be similar to the preoperative values.
Montés-Micó
Robert
R
Optometry Research Group, Optics Department, Faculty of Physics, University of Valencia, Valencia, Spain. robert.montes@uv.es
Ferrer-Blasco
Teresa
T
Charman
W Neil
WN
Cerviño
Alejandro
A
Alfonso
José F
JF
Fernández-Vega
Luis
L
D000065:Accommodation, Ocular / Q000502:physiology*; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000150:complications; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000601:surgery*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011305:Presbyopia / Q000503:physiopathology; D011474:Prosthesis Design; D019591:Pseudophakia / Q000503:physiopathology*; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*