title: Custom selection of aspheric intraocular lens in eyes with previous hyperopic corneal surgery.
abstract: OBJECTIVE
  To determine the optimum amount of spherical aberration in intra-ocular lenses (IOLs) to maximize optical quality in eyes with previous hyperopic corneal surgery.
  
  
  METHODS
  Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
  
  
  METHODS
  Theoretical simulation study.
  
  
  METHODS
  The amount of spherical aberration in the IOL was varied to produce residual ocular spherical aberration ranging from -0.50 to +0.50 μm. With the use of the Zernike Tool Program, the polychromatic point-spread function with Stiles-Crawford effect was calculated for 6.0 mm and 4.0 mm pupils and defocus of 0.00 diopter (D), -0.50 D, and +0.50 D. The IOL spherical aberration at which maximum image quality was achieved was determined. Stepwise multiple regression analysis was performed to assess the predictors of optimum IOL spherical aberration.
  
  
  RESULTS
  Aspheric IOL implantation was simulated in 106 eyes of 80 patients; ages ranged from 40 to 59 years. With 0.00 D, -0.50 D, and +0.50 D defocus, respectively, the ranges of 25th to 75th percentiles of the optimum IOL spherical aberration were -0.12 to +0.20 μm, +0.10 to +0.42 μm, and -0.35 to -0.03 μm for the 6.0 mm pupil and -0.14 to +0.26 μm, +0.41 to +0.86 μm, and -0.74 to -0.24 μm for the 4.0 mm pupil. The amount of optimum IOL spherical aberration could be predicted on the basis of other higher-order aberrations (HOAs) of the cornea with multiple correlation coefficients up to 0.98.
  
  
  CONCLUSIONS
  The amount of IOL spherical aberration producing the best image quality in eyes with previous hyperopic corneal surgery varied widely and could be predicted on the basis of the full spectrum of corneal HOAs.
  
  
  BACKGROUND
  Supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York. No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors.forename: Omar
authors.initials: O
authors.lastname: Shoukfeh
authors.affiliation: From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas. Electronic address: dkoch@bcm.edu.
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Koch
mesh_terms: D000328:Adult; D048988:Corneal Surgery, Laser; D019781:Corneal Topography; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008875:Middle Aged; D008962:Models, Theoretical; D055095:Optics and Photonics; D018918:Phacoemulsification; D011474:Prosthesis Design