title: Comparison of contrast sensitivity, depth of field and ocular wavefront aberrations in eyes with an IOL with zero versus positive spherical aberration.
abstract: OBJECTIVE
  To compare the clinical performance of the zero spherical aberration (SA) SofPort LI61AO (AO, Bausch & Lomb) intraocular lens (IOL) to the AcrySof SA60AT (AT, Alcon), which has positive spherical aberration.
  
  
  METHODS
  Patients underwent uneventful phacoemulsification with implantation of either an aspheric (AO, n = 19) or spherical (AT, n = 20) IOL. Postoperatively, a 5 mm artificial pupil was positioned in trial frames with the cycloplegic refraction during monocular, mesopic contrast sensitivity (CSF) and low-contrast visual acuity (LCVA) testing with glare. Ocular and corneal wavefront error was determined at 5 mm diameters.
  
  
  RESULTS
  Mean CSF scores were better at all frequencies tested for the AO than for the AT group, and achieved statistical significance at 1.5 cpd (p = 0.038) and 6 cpd (p = 0.017). With glare, AO eyes read 30.9 +/- 5.0 low-contrast letters versus 25.2 +/- 6.8 for AT eyes (p = 0.005) (mean DeltaLogMAR = -0.10), while high-contrast acuity and refraction were similar. Eyes implanted with the SA60AT had 43% greater positive spherical aberration at a 5 mm wavefront diameter, with no significant difference in corneal SA between groups. A through-focus analysis demonstrated a similar depth of field, yet a comparatively higher visual Strehl ratio for the aspheric IOL at emmetropia (p = 0.038).
  
  
  CONCLUSIONS
  Eyes with the SofPort Advance Optics neutral aberration IOL demonstrated less spherical aberration and better low-contrast acuity compared to eyes with a spherical IOL, without sacrificing tolerance to defocus. The aspheric IOL showed superior optical and clinical performance, which is most likely due to its surface design.
authors.affiliation: Pepose Vision Institute, 1815 Clarkson Road, Chesterfield, MO 63107, USA. jpepose@peposevision.co
authors.forename: Jay S
authors.initials: JS
authors.lastname: Pepose
authors.forename: Mujtaba A
authors.initials: MA
authors.lastname: Qazi
authors.forename: Keith H
authors.initials: KH
authors.lastname: Edwards
authors.forename: Jeff P
authors.initials: JP
authors.lastname: Sanderson
authors.forename: Edwin J
authors.initials: EJ
authors.lastname: Sarver
mesh_terms: D000368:Aged; D002387:Cataract Extraction / Q000379:methods*; D015350:Contrast Sensitivity; D019781:Corneal Topography; D005260:Female; D005403:Fixation, Ocular; D019466:Glare; D006801:Humans; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011184:Postoperative Period; D011474:Prosthesis Design; D011932:Reading; D012029:Refraction, Ocular; D014792:Visual Acuity