The influence of preoperative corneal spherical aberration on relatively personalized implantation of aspheric intraocular lens

Objective To analysis the feasibility of selectively targeting zero total postoperative spherical aberration by selecting the best fit aspheric intraocular lens (IOL) based on preoperative corneal spherical aberration of patients. Methods It was a prospective case series study. The corneal spherical aberration(Z40) with 6 mm aperture of 57 eyes (46 patients ) was measured with a iTrace Visual Function Analyzer 1 day before surgery, the target postoperative total spherical aberration was set at zero. Thus, for corneal spherical aberration ＜ +0. 100 μm, the Sofport Advanced Optic( AO)IOL( 10 eyes)was selected; for corneal spherical aberration ＞ +0. 100 μm but if ＜ +0. 235 μm, the AcrySof IQ IOL(20 eyes) was selected; and for corneal spherical aberration ＞ +0. 235 μm, Tecnis ZA9003 IOL(27 eyes)was selected.Aspherical IOL was implanted after phacoemulsification through a clear-cornea, 3. 2 mm incision without suture. Uncorrected visual acuity, best corrected visual acuity( BCVA ), spherical aberration of the whole eye and internal optics (IOL) at 6 mm pupil diameter were examined at 3 months postoperatively. ANOVA and t-test were used to analyze the data at 3 months postoperatively. Results Total postoperative ocular spherical aberration at 6 mm pupil diameter for the entire population measured (0. 015 ±0. 056)μm[ AO:(0. 081 ±0. 013 ) μm;IQ: (0. 006 ± 0. 038 ) μm;Tecnis: (0. 007 ± 0. 070) μm ]. For the entire population,there was no significantly different between the predicted value and actual value of ocular spherical aberration at 6 mm pupil diameter: t = 1. 983, P = 0. 052 ( AO: t = 1.957, P = 0. 082; IQ: t = 0. 030, P = 0. 976;Tecnis:t =2. 031, P =0. 053). For the entire population, the predictive error measured (0. 014 ±0. 044)μm[ AO: (0. 006 ±0. 012) μm;IQ: ( -0. 000 ±0. 037) μm ;Tecnis: (0. 027 ± 0. 052) μm;F = 2. 626, P =0. 082 ]. The postoperative visual activity was not significantly different among the three groups ( P ＞ 0. 05 ).Conclusion Customized selection of aspheric IOL based on preoperative corneal spherical aberration of patients is feasible and produces satisfactory target postoperative total spherical aberration. Key words: Phacoemulsification; Cataract; Lenses,intraocular; Corneal topography