Measurement of corneal aberrations for customisation of intraocular lens asphericity: impact on quality of vision after micro-incision cataract surgery.
OBJECTIVE
To compare the quality of vision of patients with customised aspheric intraocular lenses (IOL) versus patients implanted with zero-aberration IOL after a 1.8 mm micro-incision cataract surgery (MICS).


METHODS
Fourty-three eyes were divided into two groups: 17 eyes (reference group) received zero aberration Acri.Smart 46LC and 26 eyes received a customised-aspheric IOL: either aspherical Acri.Smart 36A, generating a -0.18 microm SA compensation equivalent, or zero-aberration Acri.Smart 46LC. IOL asphericity was individually selected according to the corneal spherical aberration (SA) in order to produce a residual ocular SA close to +0.10 microm. Refraction, best-corrected visual acuity (BCVA), contrast sensitivities, ocular wavefront aberrations and objective quality of vision assessment were analysed 6 months after MICS.


RESULTS
Postoperative BCVA was similar in both groups (p=0.58). Mesopic contrast sensitivities were significantly better in the custom group at intermediate and high spatial frequencies (p<0.001), while photopic contrast sensitivities were similar. Total SA was significantly lower in the custom group (Z(4)(0)=0.085+/-0.075 vs 0.261+/-0.091 microm, p<0.001), whereas no difference was found in preoperative corneal SA. Modulation transfer function cut-off frequency was higher in the custom group than in the reference group (34.3+/-8.1 vs 23.57+/-8.6 cycles per degree, respectively; p=0.008).


CONCLUSIONS
Individual selection of IOL asphericity with a preoperative corneal SA measurement allowed control of final ocular SA. Such customisation improves mesopic contrast sensitivity, and leads to better objective quality of vision.
Nochez
Yannick
Y
Department of Ophthalmology, University Hospital of Tours, 2 boulevard Tonnellé, Tours F-37000, France. yannick.nochez@free.fr
Favard
Anne
A
Majzoub
Samuel
S
Pisella
Pierre-Jean
PJ
D000368:Aged; D002387:Cataract Extraction / Q000379:methods*; D015350:Contrast Sensitivity / Q000502:physiology; D057108:Corneal Wavefront Aberration / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000592:standards*; D007910:Lenses, Intraocular; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology