Higher-order aberrations and spherical aberration in various age groups after LASIK and cataract surgery

To evaluate higher order aberrations and spherical aberration in various age groups after corneal and lenticular treatments.

Two hundred forty untreated eyes across various age groups and 182 eyes post-corneal or lenticular treatment were included and iTrace (Tracey Technologies, Houston, Texas) aberrometry measurements were gathered. Treated patients were classified into 2 groups according to treatment administered: eyes that underwent different algorithms of laser in situ keratomileusis (Lasik) demonstrating quantifiable differences in corneal aberrations, and eyes that underwent uncomplicated phacoemulsification with in-the-bag implantation of aspheric neutral EnVista MX60 (Bausch & Lomb, USA), negative aspheric Tecnis ZCB00 (Johnson and Johnson, USA), or spherical Akreos Adapt (Bausch & Lomb, USA) intraocular lens (IOL) showing differences in internal spherical aberrations.

Aging was associated with less myopic refractions (p = 0.0001) and an increase in internal spherical aberration (p = 0.0001). Following corneal refractive surgery, the corneal spherical aberration measured through 3 mm pupils for Standard LASIK, Zyoptix wavefront-aspheric Lasik, Supracor Myopic Lasik, and Supracor Hyperopic Lasik, were + 0.054 um, + 0.074 um, -0.013 um, and - 0.032 um, respectively. (p = 0.001) Following cataract surgery and measured through 5 mm pupils, the internal spherical aberration were significantly lower in the neutral aspheric EnVista and negative aspheric Tecnis compared to spherical Akreos Adapt IOLs, calculated to be + 0.022 um, -0.150 um, and + 0.094 um, respectively. (p = 0.00) CONCLUSION: The study indicated a trend of increasing internal spherical aberration with age. In Lasik surgery, manipulating spherical aberration in the corneal periphery improves overall vision while in the central cornea provides presbyopic treatment. In cataract surgery, patients with larger scotopic pupil sizes may benefit more from aspheric IOLs.