Fellow-eye comparison of 2 aspheric microincision intraocular lenses and effect of asphericity on visual performance

To evaluate visual performance and aberrations with aspheric and spherically neutral microincision intraocular lenses (IOLs) and assess the influence of asphericity on visual performance, wavefront aberration, and depth of focus.

St. Thomas' Hospital, London, United Kingdom.

Clinical trial and cohort study.

In the first study, patients with bilateral cataract were randomized to receive an aspheric Acri.Smart 36A IOL or a spherically neutral Akreos MI60 IOL in the first eye. The other IOL was implanted in the second eye within 3 weeks. Assessments at 3 months were 100% and 9% corrected distance visual acuity (CDVA) and distance-corrected near visual acuity (DCNVA). Aberrations and depth of focus were computed using iTrace software. In the second study, data from the other published study was combined to assess the visual performance, aberration, and depth of focus in groups of spherical, spherically neutral, and negatively aspheric (asphericity -0.17 μm) IOLs.

In part 1, there was no difference in 100% or 9% CDVA, DCNVA, or depth of focus between the 2 microincision IOLs. Total spherical aberration was lower with the aspheric IOL. In part 2, the CDVA and DCNVA were not different between the spherical (n = 44), spherically neutral (n = 32), or aspheric (n = 76) IOLs. Total spherical (P<.01) and vertical coma aberrations decreased with increasing IOL asphericity (P<.01). Depth of focus (4.0 mm pupil) also decreased with increasing asphericity and was significant between the spherical IOL and aspheric IOLs. The DCNVA did not differ between groups.

Asphericity of IOLs did not affect distance visual acuity. The difference in depth of focus was significant only between negatively aspheric and spherical IOLs. Asphericity differences up to 20 μm did not influence depth of focus.