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The Impact of a Modified Optic Design on Visual Functions. A Clinical Comparative Study
1Mester U., 2Dillinger P., 1Anterist N. B.,
1Bundesknappschaft Sulzbach/Saar, Augenklinik (Sulzbach/Saar)
2Augenklinik der Bundesknappschaft (Sulzbach/Saar)
Purpose: Several investigations showed an increasing positive spherical aberration of the older eye. An aspheric design of the anterior surface of an IOL is expected to compensate for this aberration leading particularly to an improved contrast sensitivity.
Method: In a randomized study in 45 patients with bilateral cataract an IOL with modified anterior surface (Tecnis Z 9000, Pharmacia) was compared intraindividually to a biconvex lens with spherical surfaces (SI 40, Allergan). After 1 and 3 months the following investigations were performed: assessment of the anterior and posterior segment, pupil size, high and low contrast visual acuity , photopic and mesopic contrast sensitivity, corneal aberration and wavefront aberration of the eye.
Results: 37 patients were examined at all follow-up visits. Although the eyes with the Tecnis IOL showed significantly better BCVA after three months, the improved quality of vision is more apparent when assessing low contrast visual acuity and contrast sensitivity. Wavefront measurements revealed no significant spherical aberration (Z 4,0) in the eyes with the Tecnis IOL while there was significantly positive spherical aberration in the eyes with the SI 40.
Conclusions: Our clinical results confirm the theoretical preclinical calculations that the spherical aberration of the eye after cataract surgery can be eliminated by modifying the anterior surface of the IOL. The Tecnis Z 9000 lens compensates for the positive spherical aberration of the older eye. This leads to a significant improvement particularly in contrast sensitivity and mesopic visual quality. These findings suggest that the reduction of spherical aberration is more likely to result in an "owl" instead of an "eagle eye".