Clinical Studies On Tecnis Z9003 Aspheric Intraocular Lens

Objective:To compare the quality of vision with aspheric intraocular lens (Tecnis Z9003) and spherical intraocular lens(Sensar AR40e) in pseudophakic patients.Methods:Stdand phacoemulsifications and IOL implantations were performed in 95(100 eyes)age related cataract patients,aged from 50 to 82(68.5±6.4).Visual acuity all were over 0.8.Based on different IOL,we divided them into 2 groups.We selected Tecnis Z9003 IOL as test group(50 patients,50 eyes),and Sensor AR40e IOL as control group(45 patients,50 eyes).Ophthalmologic examination including uncorrected distance visual acuity(UCDVA),best spectacle-corrected distance visual acuity(BCDVA),pupil size,corneal aberration,total wavefront aberration and contrast sensitivity under mesopic and photopic conditions with or without glare, Modulation transfer function,distance-corrected near visual acuity(DCNVA), Modulation transfer function under different defocus 1 months postoperatively.Results:(1) Age of the patients,UCDUA,BCDVA between 2 groups,is not significantly different 1 month postoperatively.(2) corneal aberration:All the corneal aberration increased when the pupil diameter increased in spherical and aspheric IOLgroups.there was no significant difference in all the corneal aberration between the two groups 1 months postoperatively in 5.0mm pupil diameter(P>0.05).(3) Total wavefront aberration:All the aberration increased when the pupil diameter increased in spherical IOL group.The spherical aberration and 4th aberration did not increase when the pupil diameter increased;but the other aberration increased with the pupil diameter increasing in aspheric IOL group.No significant difference was found between the two groups in all the aberration of 3mm pupil diameter 1 month postoperatively.A significant difference was found between the two groups in C12 and 4th aberration of 4mm pupil diameter 1 month postoperatively,but the others was not.A significant difference was found between the two groups in C12,4th aberration and total high aberration(P<0.05) of 5mm pupil diameter 1 month postoperatively, but the others was not(P>0.05).(4)CS:Aspheric IOL showed better contrast sensitivity compared to spherical IOL at spatial frequencies of 6,12,18cpd under photopic conditions without glare,photopic conditions with glare,mesopic conditions without glare;12,18cpd under mesopic conditions with glare 1 month postoperatively with the best corrected visual acuity.(5) MTF_(HOA) and MTF_(SA): When the pupil diameter increased,the MTF_(HOA) of spherical IOL group decreased significantly at 5,10,15cpd,but that was not significantly difference at 20,25, 30cpd.The MTF_(SA) of spherical IOL group decreased at all spatial frequencies with the pupil diameter increaseing.When the pupil diameter increased,the MTF_(HOA) of aspheric IOL group decreased significantly at 5,10,15,20cpd,but that was not significantly difference at 25,30cpd.The MTF_(SA) of aspheric IOL group did not significantly change at all spatial frequencies with the pupil diameter increaseing.When the pupil diameter was 3.0mm,the MTF of the two IOL were not significant difference at all the spatial frequencies.When the pupil diameter was 4.0mm,the MTF_(HOA) of the aspheric IOL group was better than that of spherical IOL group at 5,10,15cpd,but the MTF_(HOA) of the two IOL groups were not significant difference at 20,25,30cpd.But the MTF_(SA) of the aspheric IOL group was better than that of spherical IOL group at all the spatial frequencies.When the pupil diameter was 5.0mm,the MTF_(HOA) of the aspheric IOL group was better than that of spherical IOL group at 5,10,15,20cpd,but the MTF_(HOA) of the two IOLs groups were not significant difference at 25,30cpd.The MTF_(SA) of aspheric IOL group was better than that of spherical IOL group at all the spatial frequencies.(6) The optical quality of BCDVA:BCDVA between 2 groups 1 month postoperatively is not significantly different.MTF_(HOA) of the aspheric IOL group was better than that of spherical IOL group at 5,10,15cpd under the BCDVA 1 month postoperatively.Aspheric IOL showed better CS compared to spherical IOLs at spatial frequencies of 6,12,18 cpd under photopic conditions without glare with the BCDVA.(7) DCNVA and pupil diameter:Spheric IOL showed better DCNVA compared to aspheric IOL 1 month postoperatively.Pupil diameter between 2 groups is not significantly different 1 month postoperatively under photopic and mesopic conditions.(8) The MTF of different defocus condition:The MTF of the aspheric IOL group was better than that of spherical IOL group at 5,10,15cpd under focus.The MTF of the aspheric IOL group was better than that of spherical IOL group at 5,10,15,20cpd with -0.50D defocus.The MTF of the two IOL groups were not significant difference at all the spatial frequencies with -1.0D defocus.The MTF of the spherical IOL group was better than that of aspheric IOL group at 5,10,15cpd with -1.5D,-2.0D defocus.Conclusion:All the corneal aberration increased when the pupil diameter increased in spherical and aspheric IOL groups.The total aberration increased with the pupil diameter increaseing in both IOL groups too.When the pupil diameter was small,the aspheric IOL cound not degrade the spherical aberration significantly.With the pupil diameter increasing,the aspheric IOL had less spherical aberrations and performed better under both photopic and mesopic CS with or without glare compared to the spherical IOL.The aspheric IOL can improved MTF at certain spatial frequencies.Best corrected optical quality of aspheric IOL is significantly better compared with spherical IOL.But Aspheric IOL showed worse DCNVA compared to spherical IOL 1 month postoperatively.Depth of focus may degrade in aspheric IOL eyes.Although best corrected optical quality is significantly better with aspheric IOL,tolerance to defocus tended to be lower.