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Pierre-Jean Pisella, Naoual Tarfaoui, Yannick Nochez; Depth Of Focus And Multifocality Of Pseudophakic Aspheric Profiles. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1388.
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The aim of this clinical study was to assess near vision ability and clinical depth of focus with different multifocal pseudophakic aspheric profiles after microincision cataract surgery.
Forty consecutive eyes (20 patients) were divided into two clinical groups after 1.8 mm microincision cataract surgery in both eyes.The first group (28 eyes, 14 patients) received an aspherical AcriSmart 36A® intraocular lens (Carl Zeiss Meditec, USA), generating a negative -0,20 µm of spherical aberration. The study group (12 eyes, 6 patients) received a zero-aberration AcriSmart 46LC® intraocular lens (Carl Zeiss Meditec, USA) on the non-dominant eye and a negative AcriSmart 36A® on the dominant eye.Inclusion criteria were a preoperative corneal spherical aberration comprised between 0,20 and 0,30 µm with a postoperative visual acuity superior to 20/20, without any refractive spherical difference in the manifest refraction over 0,5 diopters.Postoperative evaluations were conducted 6 months after surgery and included visual acuity measurement for distance, intermediate and near vision; binocular and monocular defocus curve with the best refraction; stereoscopic vision and wavefront corneal and total aberration analysis (KR1®, Topcon).
Residual postoperative spherical equivalent of the manifest refraction and best corrected distance visual acuity was not different between the two clinical groups (respectively p = 0,11 and p = 0,82).However, patients of the study group (36A®/46LC®) presented a best monocular and binocular visual acuity for intermediate and distance vision (between -2 and -4 diopters of defocus, p<0,05) despite of no differences between spherical and cylindrical manifest refraction.Mean of total spherical aberration was about 0.023 µm at 6mm pupil diameter for the first group (36A®/36A®) and about 0.185 µm for the study group (p=0,08).
Differences in pseudophakic aspherical profiles of intraocular lenses in cataract surgery seemed to increased clinical depth of focus and near ability. Some prospective studies of dominance and adaptative optics would be necessary to evaluate the link between spherical aberration, higher order aberrations profile and generated depth of focus.
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