Analysis Of The Visual Quality Of Different Spherical Aberration Aspherical IOL In Cataract Surgery

Objective:To compare the visual quality after individual choice and implantation of three different spherical aberration(spherical aberation,SA)0,-0.20μm and-0.27 μm aspherical intraocular lens(IOL)with choice and implantation of zero SA IOL directly.Can individual choice of IOL eye achieve the desired full eye SA?To compare the visual quality with bigger and smaller Coma、bigger Coma and zero SA IOL directly in the patients who reach the expected value all eyes SA.Methods:Selection 125 cases(145 eyes)of cataract patients in eye departmengt of the second affiliated hospital of kunming medical university,measured the higher order aberrations of the anterior cornea by iTrace full visual function analyzer in preoperative.According to the corneal spherical aberration(SA)values divided them into two groups A、B,the group A(91 eyes)implanted three different 0、-0.20μm、-0.27μm spherical aberration aspherical IOL,according to different divided into A1 implanted IOL(30 eyes),A2(32 eyes),A3(29 eyes)group,with full eye SA is equal to the IOL and postoperative corneal SA algebra and the formula for calculating,expected after the full eye SA reserve about + 0.1p,m;and the control group B(54 eyes)implanted the 0 spherical aberration aspherical IOL.Measured and analyzed the all eye and corneal high-order aberration、modulation transfer function(MTF)、strehl ratio(SR)and best corrected visual acuity(BCVA)after 3 months of operations.Results:(1)The corneal spherical aberration differences before and after operation had no statistical significance(P>0.05),the changes of total coma、trefoil and higher order aberrations(tHOA)were also similar to it.(2)The BCVA difference of two groups patients had no statistical significance(P>0.05).(3)Under the pupil diameter of 3mm,the differences of corneal SA、MTF and SR value in the two groupsIOL eyes had no statistical significance(P>0.05);Total spherical aberation difference were statistically significant(P =0.019),the differences of three experimental groups had no statistical significance(P>0.05),but they all<D group(P=0.000).(4)Under the pupil diameter 5mm,the differences of corneal SA in the four groups IOL eyes had no statistical significance(P>0.05);The differences of total SA and tHOA were statistically significant,A<B group(P =0.000),the differences of A1,A2,A3 experimental groups had no statistical significance(P>0.05);All eyes MTF tHOA difference in SR and has no statistical significance(P>0.05).(5)In group A all eyes SA there was no statistically significant difference between actual measured value and predicted value(P>0.05).(6)In group A with strong Coma IOL eyes(32 eyes,Coma>0.37μm,I group)accounted for 35%,smaller Coma(59 eyes,Coma 0.37μm or less,group Ⅱ)accounted for 65%,in the pupil diameter of 5 mm,Ⅰ and ⅡB group full eye MTFtHOA and SR value difference was statistically significant,Ⅱ>I group(P<0.05),I>B group(P<0.05).Conclusions:(1)There is no difference of corneal spherical aberration after the phacoemulsification.Small pupil diameter,there is no difference of visual quality in the aspherical IOL eye of different spherical aberration design.Under pupil diameter,to choose aspherical IOL according to corneal SA personalizedly by preoperative examine can get higher visual quality than randomly choose 0 SA aspherical IOL.(2)The iTrace full visual function analyzer is used to measure the preoperative corneal high-order aberration,guide individualized choice different SA aspherical IOL,postoperative can achieve the desired eye SA.(3)Under the pupil diameter,individual choice different SA the IOL eyes of smaller Coma patients(0.37 microns or less)than larger Coma patients(>0.37 microns)for better visual quality,larger Coma patients than randomly choose 0 SA aspherical IOL.