Evaluation of Visual Quality in Pseudophakic Eyes with Different Ocular Spherical Aberrations

Purpose: To evaluate the effects of different residual total ocular spherical aberration (SA) on objective and subjective visual quality in pseudophakic eyes. Methods: This prospective consecutive study comprised 171 patients with age-related cataract and undergone unilateral uneventful phacoemulsification. All participants were divided into four groups based on residual ocular SA at 6 mm pupil: negative SA (≤-0.10 μm, group A), neutral SA (0.00 ± 0.05 μm, group B), slightly positive SA (0.10 ± 0.05 μm, group C), and more positive SA (0.20 μm, group D), respectively. Subjective visual acuity and contrast sensitivity, and objective optical quality and ocular aberrations were analyzed 3 months postoperatively. Results: There was no significant difference in baseline measurements across all groups. Postoperatively, no statistically significant differences were found in visual acuity between groups (P > .05), while differences reached statistical significance in mesopic contrast sensitivity at 12 and 18 cpd (P < .01). There were significant differences in ocular SA and higher-order aberrations at 6 mm pupil, as well as in optical quality parameters (P < .05). Group C showed a minimum value of objective scatter index (1.17 ± 0.55) but maximum values of modulation transfer function cutoff (31.94 ± 9.18) and optical quality value OV 100% (1.07 ± 0.31), indicating lower intraocular scattering and superior optical quality. Conclusions: This comprehensive evaluation is conducive to deepening the understanding of visual and optical performance of pseudophakic eye. A modest amount of positive ocular SA seemed to be a more preferable option for enhancing visual quality after aspheric ntraocular lense (IOL) implantation.