Monochromatic Higher Order Aberrations in Patients Undergoing Cataract Surgery with an Aspheric Intraocular Lens

摘要

Purpose: To evaluate the effectiveness of an aspheric intraocular lens (IOL) in reducing monochromatic higher order aberrations (MHOA) following routine phacoemulsification and IOL implantation. Methods: Prospective, observational study of 50 patients with visually significant cataract who underwent uncomplicated cataract extraction and aspheric IOL implantation. Whole eye, corneal and internal MHOA were measured before, and four weeks after, surgery. Pre and post-operative data was compared to 300 eyes of 167 age-matched patients with no visually significant cataract. MHOAs were measured over a 5 mm dilated pupil diameter using the iTrace aberrometer (Tracey Technologies, Houston, TX). Zernike coefficients were obtained to the 6th order. Results: There was a significant reduction in total root mean square (RMS) MHOA following cataract surgery (p0.001). Whole eye mean MHOA reduced from 0.729 ?μm to 0.484 ?μm (p0.001) and mean internal MHOA reduced from 0.681 ?μm to 0.475 ?μm (p0.001). The RMS of total internal 3rd (p0.001), 4th (p0.001), 5th (p=0.033) and 6th (p=0.006) orders also showed a significant reduction post-operatively. Internal spherical aberration (SA; Z(4,0)) also showed a significant reduction from 0.172 ?μm to 0.071 ?μm (p=0.004). Post-operative whole eye MHOAs (mean 0.484 ?μm) were found to be significantly less (p0.001) than age match controls (mean 0.648 ?μm). Post-operative whole eye (mean 0.133 ?μm) and internal SA (mean 0.071 ?μm) was found to be significantly less than control cases (mean 0.223 ?μm; p0.001 and mean 0.133; p=0.022 respectively). Conclusions: Implantation of an aspheric IOL during cataract surgery significantly reduces both internal and whole eye MHOA. Post-operative MHOAs in patients with an aspheric IOL are significantly less than age matched controls with clear optical media and no visually significant cataract. These changes may contribute to greater patient satisfaction and improved visual function following cataract surgery.