Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses

Susana Marcos, Patricia Rosales, Lourdes Llorente, Ignacio Jiménez-Alfaro

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Purpose: To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Setting: Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Methods: Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. Results: The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z3 -3) and negative tetrafoil (Z4 4). The mean vertical astigmatism increased by 2.47 μm ± 1.49 (SD) and 1.74 ± 1.44 μm, vertical trefoil increased by 1.81 ± 1.19 μm and 1.20 ± 1.34 μm, and tetrafoil increased by -1.10 ± 0.78 μm and -0.89 ± 0.68 μm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups, although there was a tendency toward more terms or orders changing statistically significantly in the Tecnis group, which had slightly higher amounts of induced aberrations. Conclusions: Cataract surgery with a small superior incision induced consistent and significant changes in several corneal Zernike terms (vertical astigmatism, trefoil, and tetrafoil), resulting in a significantly increased overall corneal RMS wavefront error. These results can be used to improve predictions of optical performance with new IOL designs using computer eye models and identify the potentially different impact of incision strategies on cataract surgery.

Original languageEnglish
Pages (from-to)217-226
Number of pages10
JournalJournal of Cataract and Refractive Surgery
Volume33
Issue number2
DOIs
Publication statusPublished - Feb 2007
Externally publishedYes

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Intraocular Lenses
Cataract
Astigmatism
Pupil
Corneal Topography
Silicones
Coma
Computer Simulation
Spain
Loteae
Research

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses. / Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio.

In: Journal of Cataract and Refractive Surgery, Vol. 33, No. 2, 02.2007, p. 217-226.

Research output: Contribution to journalArticle

Marcos, Susana ; Rosales, Patricia ; Llorente, Lourdes ; Jiménez-Alfaro, Ignacio. / Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses. In: Journal of Cataract and Refractive Surgery. 2007 ; Vol. 33, No. 2. pp. 217-226.
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N2 - Purpose: To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Setting: Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Methods: Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. Results: The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z3 -3) and negative tetrafoil (Z4 4). The mean vertical astigmatism increased by 2.47 μm ± 1.49 (SD) and 1.74 ± 1.44 μm, vertical trefoil increased by 1.81 ± 1.19 μm and 1.20 ± 1.34 μm, and tetrafoil increased by -1.10 ± 0.78 μm and -0.89 ± 0.68 μm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups, although there was a tendency toward more terms or orders changing statistically significantly in the Tecnis group, which had slightly higher amounts of induced aberrations. Conclusions: Cataract surgery with a small superior incision induced consistent and significant changes in several corneal Zernike terms (vertical astigmatism, trefoil, and tetrafoil), resulting in a significantly increased overall corneal RMS wavefront error. These results can be used to improve predictions of optical performance with new IOL designs using computer eye models and identify the potentially different impact of incision strategies on cataract surgery.

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