title: Visual simulation through different intraocular lenses using adaptive optics: effect of tilt and decentration.
abstract: OBJECTIVE
  To analyze visual quality differences between intraocular lenses (IOLs) and assess the impact of IOL decentration and tilt on visual quality.
  
  
  METHODS
  University of Valencia, Valencia, Spain.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  The crx1 adaptive optics visual simulator was used to simulate the wavefront aberration pattern of 2 commercially available aspheric aberration-correcting IOLs (Acrysof IQ SN60WF and Tecnis ZA9003) and 2 spherical IOLs (Akreos Adapt and Triplato) in 5 situations: centered, decentered 0.2 mm and 0.4 mm, and tilted 2 degrees and 4 degrees. Monocular distance visual acuity at 100%, 50%, and 10% contrast and the depth of focus were measured.
  
  
  RESULTS
  Ten eyes of 10 patients were evaluated. When the IOLs were centered, there were no differences in visual acuity between the 4 IOLs at any contrast. The aberration-correcting IOLs were more sensitive to tilt and decentration than the spherical IOLs; Tecnis ZA9003 IOL was the most sensitive to decentration and the Acrysof IQ SN60WF IOL was the most sensitive to tilt. Higher residual spherical aberration slightly improved depth of focus and the tolerance to defocus.
  
  
  CONCLUSIONS
  The results in this study suggest that the aspheric aberration-correcting and spherical IOLs provided comparable visual quality when centered in eyes in which the corneal higher-order aberrations are those of the average of the human cornea. Tilt and decentration of the IOLs had an impact on visual quality, with aberration-correcting IOLs having a greater effect than the spherical IOLs.
authors.affiliation: Optics Department, Faculty of Physics, University of Valencia, Spain. david.madrid@uv.es
authors.forename: David
authors.initials: D
authors.lastname: Madrid-Costa
authors.forename: Javier
authors.initials: J
authors.lastname: Ruiz-Alcocer
authors.forename: Cari
authors.initials: C
authors.lastname: Pérez-Vives
authors.forename: Teresa
authors.initials: T
authors.lastname: Ferrer-Blasco
authors.forename: Norberto
authors.initials: N
authors.lastname: López-Gil
authors.forename: Robert
authors.initials: R
authors.lastname: Montés-Micó
mesh_terms: D057128:Aberrometry; D000328:Adult; D060437:Artificial Lens Implant Migration / Q000503:physiopathology*; D015331:Cohort Studies; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D003867:Depth Perception / Q000502:physiology*; D006801:Humans; D007910:Lenses, Intraocular; D008962:Models, Theoretical; D019591:Pseudophakia / Q000503:physiopathology*; D011601:Psychophysics; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult