Optical behavior of the eye implanted with extreme intraocular lens powers

J Cataract Refract Surg. 2019 Aug;45(8):1113-1118. doi: 10.1016/j.jcrs.2019.03.003. Epub 2019 May 21.

Abstract

Purpose: To evaluate the induced ocular aberrations after cataract surgery with extreme low- powered and high-powered spherical monofocal intraocular lenses (IOLs) using a new pyramidal wavefront sensor aberrometer.

Setting: Vissum Instituto Oftalmológico, Alicante, Spain.

Design: Prospective observational comparative study.

Methods: This study included patients who had cataract surgery with implantation of a spherical monofocal IOL. The patients were divided into three groups according to the IOL power. Group 1: +20 diopters (D) to +23 D; Group 2: less than +10 D; and Group 3: +29 D or more. Assessment after 3 months included: uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, contrast sensitivity function test (Ginsburg), corneal aberrometry, and total ocular aberrometry with a pyramidal wavefront sensor aberrometer (Osiris) for 4.0 mm, 4.5 mm, and 5.0 mm pupil diameters.

Results: The study comprised 88 eyes of 56 patients. There were no differences between all groups in terms of refractive error, corneal aberrometry, or total ocular higher-order aberrations at any analyzed pupil diameter. The ocular spherical aberration (SA) was not significantly different between groups with a 4.0 mm pupil. The SA was significantly lower in Group 2 when compared with Group 1 and Group 3 for both 4.5 mm (P = .01 and P = .001, respectively) and 5.0 mm (P = .002 and P = .002, respectively). There was no significant difference in SA between Group 1 (+20 D to 23 D) and Group 3 (≥+29 D) at any analyzed pupil diameter. Higher SA did not correlate to lower contrast sensitivity.

Conclusions: Despite the theoretical evidence, only a negligible amount of clinically insignificant aberrations were induced by high-powered positive IOLs. Low-powered IOLs did not induce significant levels of SAs.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aberrometry
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Sensitivity / physiology
  • Corneal Wavefront Aberration / etiology*
  • Corneal Wavefront Aberration / physiopathology
  • Female
  • Humans
  • Lens Implantation, Intraocular*
  • Lenses, Intraocular / adverse effects*
  • Male
  • Middle Aged
  • Optics and Photonics
  • Phacoemulsification / adverse effects*
  • Prospective Studies
  • Pseudophakia / etiology
  • Pseudophakia / physiopathology
  • Refraction, Ocular / physiology*
  • Refractive Errors / etiology*
  • Refractive Errors / physiopathology
  • Visual Acuity / physiology*