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Measurement of corneal aberrations for customisation of intraocular lens asphericity: impact on quality of vision after micro-incision cataract surgery
  1. Yannick Nochez,
  2. Anne Favard,
  3. Samuel Majzoub,
  4. Pierre-Jean Pisella
  1. Department of Ophthalmology, University Hospital of Tours, Tours, France
  1. Correspondence to Dr Nochez Yannick, Department of Ophthalmology, University Hospital of Tours, 2 boulevard Tonnellé, Tours F-37000, France; yannick.nochez{at}free.fr

Abstract

Aims To compare the quality of vision of patients with customised aspheric intraocular lenses (IOL) versus patients implanted with zero-aberration IOL after a 1.8 mm micro-incision cataract surgery (MICS).

Methods Fourty-three eyes were divided into two groups: 17 eyes (reference group) received zero aberration Acri.Smart 46LC and 26 eyes received a customised-aspheric IOL: either aspherical Acri.Smart 36A, generating a −0.18 μm SA compensation equivalent, or zero-aberration Acri.Smart 46LC. IOL asphericity was individually selected according to the corneal spherical aberration (SA) in order to produce a residual ocular SA close to +0.10 μm. Refraction, best-corrected visual acuity (BCVA), contrast sensitivities, ocular wavefront aberrations and objective quality of vision assessment were analysed 6 months after MICS.

Results Postoperative BCVA was similar in both groups (p=0.58). Mesopic contrast sensitivities were significantly better in the custom group at intermediate and high spatial frequencies (p<0.001), while photopic contrast sensitivities were similar. Total SA was significantly lower in the custom group (Z40=0.085±0.075 vs 0.261±0.091 μm, p<0.001), whereas no difference was found in preoperative corneal SA. Modulation transfer function cut-off frequency was higher in the custom group than in the reference group (34.3±8.1 vs 23.57±8.6 cycles per degree, respectively; p=0.008).

Conclusion Individual selection of IOL asphericity with a preoperative corneal SA measurement allowed control of final ocular SA. Such customisation improves mesopic contrast sensitivity, and leads to better objective quality of vision.

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Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the local ethics committee (CHU Bretonneau).

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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