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Henk Weeber, Roland Pohl, Ulrich Mester, Patricia Piers; Visual Performance of Pseudophakic Eyes Corrected for Spherical and Chromatic Aberrations with an Achromatic Intraocular Lens. Invest. Ophthalmol. Vis. Sci. 2013;54(15):808.
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© ARVO (1962-2015); The Authors (2016-present)
Previous theoretical studies using computer simulations and experiments using a visual simulator have shown that the simultaneous correction of spherical aberration (LSA) and longitudinal chromatic aberration (LCA) can improve visual performance. The aim of the current study was to demonstrate the visual performance of intraocular lenses correcting both spherical and chromatic aberration in a clinical setting.
In a prospective, subject-masked, paired eye, randomized multicenter clinical study 20 patients with uncomplicated bilateral cataract had standard small incision cataract surgery conducted in 2008. An IOL correcting both LCA and LSA (IOL1) was implanted in one eye, and an IOL correcting LSA only (IOL2) was implanted in the other eye. Both IOL designs shared the same IOL platform (IOL material, optic, and haptics) and differed only in their aberration correction. Both lenses were CE marked. Visual performance of each eye was tested at 1 month and 3 month post operatively. Key evaluation criteria were best-corrected distance visual acuity (BCVA) and low contrast acuity, contrast sensitivity, color testing, optical/visual symptoms, medical and lens complication rates, adverse event rates, and subjective satisfaction questionnaire. Defocus curve testing was performed on a subset of patients.
At 1 month, best corrected visual acuity was -0.05 logMAR for the IOL1 eyes and -0.01 logMAR for the IOL2 eyes, showing no significant difference (p=0.15). At 3 month, the differences were comparable: -0.06 logMAR for the IOL1 eyes and -0.02 logMAR for the IOL2 eyes (p=0.10). The patients with good high-contrast VA (BCVA ≤ 0.0 logMAR; n=13) showed a higher gain in visual acuity (p<0.05). This is in accordance with experiments showing that correction of LCA has a more positive effect on visual quality when monochromatic aberrations are also corrected. Contrast acuity was better for eyes having IOL1 for all contrast levels. However, statistical significance was not reached (p-value ≥ 0.18).
The clinical data indicates that combined correction of longitudinal chromatic aberration and spherical aberration may have a positive effect on visual performance. The results are in agreement with previous studies using computer simulations, as well as subjective testing using a vision simulator.
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