Personalized Correction Of Spherical Aberration In Cataract Surgery Based On Corneal Spherical Aberration

Objective:To determine the effectiveness and feasibility of personalized aspheric intraocular lens (IOL) implantation based on preoperative corneal spherical aberration.Methods:Candidates for cataract surgery were offered topographical measurement by OCULUS Pentacam preoperatively. Based on the corneal spherical aberration at6-mm optical zone, one of three aspheric IOLs was chosen so the arithmetic sum of the corneal spherical aberration and pseudophakic spherical aberration came closest to zero. The three aspheric IOLs including Akreos Adapt AO (Bausch&Lomb), AcrySof IQ SN60WF (Alcon Laboratories Inc) and Tecnis ZA9003(Advanced Medical Optics [AMO]), which have spherical aberration as0,-0.20,-0.27μm, respectively. Postoperatively, corneal wavefront was mesasured by Pentacam again. Total ocular wavefront was also measured by Zywave aberrometer (Bausch&Lomb). The effectiveness was assessed by compared postoperative total ocular spherical aberration with other personalized and nonpersonalize studies. The feasibility was assessed by compared predictive value and postoperative total spherical aberration.Results:Sixty eyes of53patients were available for analysis. The Akreos Adapt AO (Bausch&Lomb) lens was implanted in6eyes (10.0%), the AcrySof IQ SN60WF (Alcon Laboratories Inc) in17eyes (28.3%), and the Tecnis ZA9003(Advanced Medical Optics [AMO]) in37eyes (61.7%).The preoperative and postoperative corneal spherical aberration at6-mm diameter were0.250±0.111μm and0.250±0.107μm respectively. The difference was not statistically significant (P=.768). Postoperative total ocular spherical aberration at6-mm diameter was 0.0365±0.0654μm, which was bigger than preoperative. But the difference was not statistically significant (P=.299). For the entire population, mean absolute predictive error measured-0.009±0.092μm;56.7%of the absolute error was within±0.05mm and81.7%, within±0.10mm.Conclusion:The personalized aspheric intraocular lens (IOL) implantation based on preoperative corneal spherical aberration is feasible; This method can reduce postoperative total ocular aberrations, and the aberration is closer to the predictive value.