Visual performance of aspherical and spherical intraocular lenses: Intraindividual comparison of visual acuity, contrast sensitivity, and higher-order aberrations

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• 作者：Thomas Kasper ; Jens Bü ; hren ; Thomas Kohnen
• 刊名：Journal of Cataract and Refractive Surgery
• 出版年：2006
• 期刊代码：145_08863350
• 类别：med
• 出版时间：December 2006
• 卷：32
• 期：12
• 页码：2022-2029
• 文件大小：311 K

摘要

Purpose

To intraindividually compare visual performance in terms of photopic high-contrast visual acuity (HCVA), mesopic HCVA, mesopic low-contrast visual acuity (LCVA), and contrast sensitivity (CS) in patients after implantation of either an aspherical or a spherical intraocular lens (IOL).

Setting

Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.

Methods

Forty eyes of 20 patients were randomized to implantation of an aspherical IOL (Tecnis Z9000, AMO) in 1 eye and a spherical IOL (Sensar AR40e, AMO) in the other eye. Three to 4 months postoperatively, photopic HCVA (270 cd/m²) was measured with the observer-independent Frankfurt-Freiburg Contrast and Acuity Test System (FF-CATS) and high-mesopic HCVA and LCVA (8 cd/m²) were measured with Early Treatment Diabetic Retinopathy Study charts. CS was assessed with the FF-CATS under photopic (167 cd/m²), high-mesopic (1.67 cd/m²), and low-mesopic (0.167 cd/m²) luminance conditions with and without glare. For each individual eye, higher-order wavefront aberrations were reconstructed for a physiological mesopic pupil diameter. Intraindividual differences (Δ_i) in visual acuity, contrast sensitivity, and higher-order aberrations (HOAs) were calculated, and the influence of age and Δ_i HOA on Δ_i contrast sensitivity (logCS) under high-mesopic conditions was investigated using multiple regression analysis.

Results

There were no statistically significant differences between the Tecnis IOL and the Sensar IOL in visual acuity measurements or contrast sensitivity measurements. For physiological mesopic pupil diameter, primary spherical aberration (Z₄⁰) was significantly lower in the Tecnis group (P<.001). For all parameters studied except Z₄⁰, the Δ_i values were distributed around zero. Multiple regression analysis showed only a partial influence of Δ_i Z₄⁰ on Δ_i logCS (adjusted R² = 0.49) but did not show any influence of age, coma-like aberration, or residual HOA.

Conclusions

Although Z₄⁰ was significantly lower in the eyes with the aspherical IOL, no statistically significant differences were found between aspherical and spherical IOLs in LCVA, HCVA, and contrast sensitivity. Statistical analysis of intraindividual contrast sensitivity differences showed that in most patients, this Z₄⁰ difference was too low to have an effect on contrast sensitivity.