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P. A. Piers, M. Bird, L. Wang, D. Koch, H. Weeber; Theoretical Performance Evaluation of Post-Myopic LASIK Eyes Implanted With IOLs With Varying Degrees of Aberration Correction. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5604.
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To assess the potential performance and limitations of available spherically and aspherically surfaced IOLs in eyes having undergone previous myopic LASIK and to evaluate new designs with the potential to provide for further performance improvements.
White-light individual eye models were constructed from clinical measurements performed on 35 patients having undergone previous myopic LASIK. The performance of three currently available IOL models with varying degrees of lenticular spherical aberration (SA) (positive SA varying for different lens powers, 0 SA, and negative SA providing a balance for the corneal SA of the average cataract patient) was evaluated in terms of RMS wavefront aberration (WA), area under the MTF curve, and radially averaged MTF for high and low spatial frequencies (6 and 30 c/deg). These post-LASIK individual eye models were then used to design and evaluate 3 new IOLs; an IOL designed to correct for the average SA present in the 35 post-LASIK eyes, IOLs designed to correct for the individual corneal SA of each patient, and IOLs designed to correct all individual WA in each patient. Through focus performance, as well as the optical quality resulting from lens misalignment with respect to the center of the pupil were also evaluated for all 6 IOL models.
Due to the high levels of positive corneal SA, of the currently available IOLs the IOL with the most negative SA provides the greatest reduction in RMS as well as the highest MTF values. Customized correction of SA results in improvements between 100% and 300% with respect to all currently available IOLs. IOLs designed for the customized correction of all higher-order aberrations provide even larger MTF improvements but are also more sensitive to defocus and misalignment errors.
Increasing levels of SA correction with an IOL with negative SA provide improved performance in post-myopic-LASIK eyes. IOLs specially designed for post-myopic-LASIK eyes show the potential to significantly improve visual performance.
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