| Objective:To compare the visual outcome after implantation ofaspheric and spheric intraocular lens(IOL),personalized and non-personalized selection of aspheric IOL,as well as of pseudophakia with different ocular SA,in patients with age-related cataract in terms of preoperative and postoperative corneal high order aberration(HOA),postoperative internal and ocular HOAs,parameters of optical quality analysis system(OQAS)and contrast sensitivity(CS),so as to provide a theoretical basis for aspheric IOL selection andvisual quality evaluation.Methods:A prospective nonrandomized controlled study was conducted and divided into three parts.The first part: forty-nine patients(91 eyes)were divided into group A with aspheric IOL and group B with spheric IOL.At 3 months postoperatively,a series of aberrations including corneal,internal and ocular HOAs,spherical aberration(SA),coma and trefoil were measured under 4mm and 6mm pupil diameter(PD)using Topcon KR-1W wave-front aberrometer;parameters including objective scatter index(OSI),modulation transfer function(MTF)cut-off,strehl ratio(SR),OQAS value(OV)at contrasts of 100%,20% and 9% were measured by OQASTMⅡ system;CS was measured by CSV-1000 contrast sensitivity tester.Statistical analysis was performed with the independent samples t test.The second part: one hundred and fifty-onepatients(162 eyes)were divided into group Afor personalized aspheric IOL andgroup B for non-personalized aspheric IOL.Patients were examined at 3 months postoperatively and the above data were similarly obtained.Statistical analysis was performed with the independent samples t test.The third part: one hundred and eight patients(171 eyes)were divided into 4 groups based onocular SA at 6mm PD,ie,group A with a negative SA value less than –0.10μm,group B with SA located between-0.05μm and 0.05μm,group C with SA from 0.051μm to 0.15μm,and group D with SA from 0.22μm to 0.32μm.The relevant data was obtained and analyzed statistically.Single factor variance analysis(ANOVA)was used to compare visual outcomes across groups,followed with pairwise comparison between groups using the least significant difference(LSD)method.Results:The first part: there was statistically significant deference in corneal tHOA and trefoil(P<0.05),no significant deference in corneal SA and coma(P>0.05)at 4 or 6mm PD between preoperative and postoperative measurements.At 3 months postoperatively,there was no statistically significant deference between aspherical IOL and spherical IOL group(P > 0.05)in uncorrected distant visual acuity(UCVA)and best corrected distant vision acuity(BCVA).There was no statistically significant difference between the two groups in corneal tHOA,SA,Coma,trefoil at 4mm and 6mm PD postoperatively(P>0.05).There was statistically significant difference between the two groups in internal SA(P<0.05),no significant in internal tHOA,Coma,trefoil at 4mm and 6mm PD(P>0.05).There was statistically significant difference between the two groups in ocular SA(P<0.05),but no significant in ocular tHOA、Coma、trefoil at 4mm PD(P>0.05).There was statistically significant difference between the two groups in ocular tHOA,SA(P<0.05),but no significant in ocularcoma,trefoil at 6mm PD(P>0.05).Postoperatively in aspheric IOL group,OSI(1.41±0.75),MTF cut off(31.46±9.65,SR(0.16±0.04),OV100%(1.05±0.33),OV20%(0.72±0.24),OV9%(0.39±0.13),in spheric IOL group,OSI(1.92±0.83),MTF cut off(25.00±9.76),SR(0.13±0.03),OV100%(0.80±0.29),OV20%(0.53±0.19),OV9%(0.29±0.10),there was statistically significant difference between the two groups in OSI,MTF cut off,SR,OV100%,OV20%,OV9%(P<0.05).For CS,there was no significant difference at the low spatial frequency(3cpd)(P> 0.05),significant differences at the middle and high spatial frequencies(6cpd,12 cpd,18cpd)between aspheric and spherical IOL groups.The second part: At 3 months postoperatively,no statistically significant deference between personalized and non-personalized IOL group(P> 0.05)in uncorrected distant visual acuity(UCVA)and best corrected distant vision acuity(BCVA),there was no significant deference in internal tHOA,SA,Coma,trefoil(P>0.05)at 4mm PD or Coma,trefoil at 6mm PD,statistically significant deferences in tHOA,SA at 6mm PD(P < 0.05).There was significant difference between the two groups in ocular SA(P<0.05),no significant difference in ocular tHOA,coma,trefoil at 4mm PD(P>0.05).There were significant differences between the two groups in ocular tHOA and SA(P<0.05),but no significant difference in ocular coma and trefoil at 6mm PD(P>0.05).Postoperatively in personalized aspheric IOL Group,OSI(1.47±0.46),MTF cut off(28.41±8.70),SR(0.15±0.04),OV100%(0.95±0.29),OV20%(0.64±0.21),OV9%(0.36±0.13),in non-personalized aspheric IOL group,OSI(1.50±0.71),MTF cut off(27.50±9.17),SR(0.15±0.04),OV100%(0.93±0.31),OV20%(0.62±0.24),OV9%(0.35±0.13),there was no significant difference between the two groups in OSI,MTF cut off,SR,OV100%,OV20%,OV9%(P>0.05).For CS,there was no significant difference at the low spatial frequency(3cpd,6cpd)(P>0.05),significant differences at the high spatial frequencies(12cpd,18cpd)between the two groups.The third part:After 3 months postoperatively,there was no significant difference among the four groups with different ocular SA in UCVA and BCVA(P>0.05).There were significant differences among the four groups in internal SA at 4mm PD(P<0.05),compared with group A,B,C,there were significant differences in group D respectively(P < 0.05).There were significant differences among the four groups in internal tHOA and SA at 6mm PD(P<0.05),tHOA: there were significant differences between group A and group C,group D respectively(P<0.05),between group B and group C,group D respectively(P<0.05),SA: there were significant differences among The four groups.There were significant differences among the four groups in ocular SA at 4mm PD(P<0.05),There were significant differences among the four groups in ocular tHOA and SA at 6mm PD(P<0.05),tHOA: there were significant differences between group A and group B,group C respectively(P < 0.05),between group D and group B,group C respectively(P<0.05),SA:there were significant differences among the four groups.Postoperatively there were significant differences among the four Groups in OSI,MTF cut off,OV100%(P>0.05).OSI: group A(1.63±0.75),group B(1.42±0.60),group C(1.17±0.55),group D(1.53±0.89),compared with group A,B,C,there were significant differences in group D respectively(P < 0.05).MTF cut off: group A(23.95±6.75),group B(28.86±10.57),group C(31.94±9.18),group D(29.44±9.46),there were significant differences between group A and group C(P<0.05).OV100%: group A(0.80±0.22),group B(0.96±0.34),group C(1.07±0.31),group D(0.99±0.31),there was significant difference between group A and group C(P<0.05).SR: group A(0.13±0.19),Group B(0.15±0.06),group C(0.16±0.04),group D(0.14±0.04),OV20% :group A(0.54±0.17),group B(0.66±0.28),groupC(0.71±0.24),group D(0.66±0.24),OV9%:group A(0.32±0.09)、group B(0.37±0.17),group C(0.40±0.14),group D(0.36±0.11),there was no significant difference among the four groups in SR,OV20%,OV9%(P>0.05).For CS,there were significant differences at the high spatial frequencies(12cpd,18cpd)between the four groups(P<0.05).In 12cpd: compaired with group A,B,C,there were significant differences in group D respectively(P<0.05),In 18cpd: compaired with group C,there were significant differences in group A、D respectively(P<0.05),there was significant difference between the group D and group B(P<0.05).Conclusion:1.Comparing aspheric IOL group with spherical IOL group,the significant difference was found inocular tHOA,SA and internal SA at 4mm and 6mm PD,OQAS parameters,middle and high spatial frequency(6cpd,12 cpd,18 cpd)CS.It was suggested that visual quality in aspheric IOL groups was better than spherical IOL groups.2.Comparing personalized aspheric IOL group with non-personalized aspheric IOL group,larger ocular HOA and high frequency CS were showed in personalized group,albeit there was no significant difference about the parameters of OQAS.It was suggested that better visual quality will be available in case of personalized selection of aspheric intraocular Lens.3.Better visual quality can be found in the group with residual SA at +0.10μm and worse visual quality in the group with negtive SA higher than-0.10μm among the four groups with different ocular SA.The best CS can be found in the group with residual SA about+0.10μm.Reducing the corneal positive SA too much lead to negative SA,which result in the lower visual quality postoperatively.Residual SA about +0.10μm contribute to the better visual quality. |
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