Purpose: To improve accuracy in intraocular lens (IOL) calculations and clarify the effect of various errors.
Setting: University eye hospitals, Mainz, Germany, and Vienna, Austria.
Methods: A numerical ray-tracing calculation has been developed for the pseudophakic eye. Individual rays are calculated and then undergo refractions on all surfaces of the IOL and cornea. The calculations do not use approximations; ie, the refractions are calculated exactly using Snell's law. Rays can be calculated for any distance from the optical axis and for other parameter variations. The effects of aspheric surfaces can also be investigated. Instead of IOL powers, manufacturers' IOL data (radii, refractive index, thickness) are used in the calculations for different IOL types. The resulting optical quality is visualized by using Landolt rings superimposed on the grid of retinal receptors.
Results: Intraocular lens design, corneal asphericity, and specific spherical aberration influence the visual quality of the pseudophakic eye significantly. The IOL refractive power is an ambiguous parameter that cannot characterize the visual outcome sufficiently accurately for an IOL implanted at a given position. The effects can be calculated only in numerical ray tracing, not in Gaussian optics. The accuracy of numerical ray tracing is independent of axial length. Therefore, very long or very short eyes gain the most from the higher accuracy of this approach. For average-size eyes, however, the results are the same as with SRK calculations.
Conclusion: Calculations in Gaussian optics should be replaced by state-of-the-art numerical methods, which can be run on any standard personal computer.