Influence of the pupil size on visual quality and spherical aberration after implantation of the Tecnis 1-piece intraocular lens

Comparison of short-term clinical outcomes of a diffractive trifocal intraocular lens with phacoemulsification and femtosecond laser assisted cataract surgery

PURPOSE

To evaluate short-term visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens (IOL) in cataract patients with phacoemulsification (PHACO) and femtosecond laser assisted cataract surgery (FLACS).

SETTING

Department of Ophthalmology, Shanghai Aier Eye Hospital, China.

DESIGN

A retrospective, observational study.

METHODS

Patients who underwent cataract surgery combined with Acrysoft IQ PanOptix trifocal IOL implantation were enrolled and divided into three groups: PHACO group, LAstig-FLACS group (astigmatism less then 1D) and HAstig-FLACS group (astigmatism more than 1D). Logarithm of the minimum angle of resolution (logMAR) visual acuity of uncorrected distance (UDVA), intermediate (UIVA), near visual (UNVA), defocus curve, surgically induced astigmatism (SIA) were evaluated in 1 months postoperatively and wavefront aberrations were evaluated in 6 months.

RESULTS

101 eyes of 60 patients were included with 31 eyes in PHACO group, 45 eyes in LAstig-FLACS group and 25 eyes in HAstig-FLACS group. Significant difference was found of internal Strehl Ratio (SR) between PHACO and LAstig-FLACS group (P = 0.026). In PHACO group, 79.31%, 86.21%, 72.41% of eyes gain visual acuity LogMAR 0.1 or more in UDVA, UIVA and UNVA, while 83.72%, 93.02%, 93.02% of those in LAstig-FLACS group and 92.00%, 84.00%, 76.00% in HAstig-FLACS group.

CONCLUSIONS

Panoptix diffractive trifocal IOL provides satisfied visual outcome in no matter FLACS or PHACO. Besides, trifocal IOL implantation via FLACS can provide a better accumulative visual acuity outcome at all distance than PHACO in 1 month. Femtosecond laser assisted limbal relaxing incisions (FLLRIs) is an excellent way to reduce a patient's corneal astigmatism.

Spherical Aberration of Astigmatic Corneas in a Cataract Population

PURPOSE

To study the distribution of spherical aberration (SA) in astigmatic corneas in a cataract population and the relationship between magnitude of corneal astigmatism and fourth-order corneal SA.

METHODS

Data routinely collected using a Scheimpflug camera (Pentacam; Oculus Optikgeräte GmbH) were retrospectively analyzed. Patients with a minimum age of 60 years were included. Total corneal SA (from anterior and posterior corneal surface) was obtained for a 6-mm cor-neal area aligned with the pupil center. Exclusion criteria were insufficient measurement quality, total deviation index (Belin/Ambrósio Deviation) greater than 1.60, and corneal thickness at the thinnest point of less than 490 μm. One eye per patient was chosen randomly. Eyes were divided into low (≤ 1.00 diopters [D]), moderate (> 1.00 to ≤ 2.00 D), and high (> 2.00 D) astigmatism groups according to the Scheimpflug measurements.

RESULTS

A total of 528 eyes were included in this analysis. Low astigmatism was found in 129 patients, moderate astigmatism in 265 patients, and high astigmatism in 134 patients. Mean astigmatism was 0.68 ± 0.24, 1.45 ± 0.28, and 2.91 ± 0.95 D in the low, moderate, and high astigmatism groups, respectively. Mean corneal SA in patients with moderate and high astigmatism was higher than in the low astigmatism group. The difference reached the significance level for the comparison of low and high astigmatism groups (P = .023). The fourth-order SA increased gradually with the magnitude of astigmatism with a slope of 0.015.

CONCLUSIONS

SA was significantly larger in the cataract population with high corneal astigmatism. The increase of positive sign SA with the magnitude of astigmatism suggests that patients with moderate to high astigmatism may benefit more from intraocular lenses with negative sign SA correction. [J Refract Surg. 2023;39(8):532-538.].

Influence of decentration and tilt of Tecnis ZCB00 on visual acuity and higher order aberrations

BACKGROUND/OBJECTIVES

To determine the influence of decentration and tilt of a pseudophakic aspheric intraocular lens (IOL) on visual acuity (VA) and higher-order aberrations (HOAs), and to analyze the agreement between pupil center/axis and iridocorneal angles center/axis when assessing IOL decentration and tilt.

SUBJECTS/METHODS

A prospective interventional case series study including thirty-three patients undergoing Tecnis ZCB00 (Abbott Medical Optics) implantation. IOL decentration and tilt with respect to two reference systems (pupil and iridocorneal angles centers/axes), in cartesian (X,Y) and polar (radius/tilt, polar angle/azimuth) coordinates, were assessed with optical coherence tomography. VA and internal and ocular HOAs were evaluated. Multiple linear regression models and intraclass correlation coefficient (ICC) were computed.

RESULTS

IOL decentration only showed a significant effect on internal HOAs for [Formula: see text] (R2 = 0.20, P = 0.04). IOL decentration with respect to the pupil center showed a significant effect on ocular [Formula: see text] (R2 = 0.18, P = 0.05), [Formula: see text] (R2 = 0.36, P = 0.001) and [Formula: see text] (R2 = 0.24, P = 0.02); and with respect to the center of iridocorneal angles, on ocular [Formula: see text] (R2 = 0.21, P = 0.03), [Formula: see text] (R2 = 0.32, P = 0.003), primary coma (R2 = 0.41, P < 0.001), and coma-like (R2 = 0.40, P = 0.001). Poor agreement between both reference systems was found for IOL decentration measurements (ICC ≤ 0.41), except for the polar angle coordinate (ICC = 0.83). Tilt measurements showed good agreement (ICC ≥ 0.75).

CONCLUSIONS

Tecnis ZCB00 decentration and tilt values after uneventful implantation appear not to have influence on VA, and their effect on HOAs are not high enough to clinically affect quality of vision. Pupil and iridocorneal angles used as reference systems may be interchangeable for IOL tilt measurements, but not for decentration.

Comparison of visual performance between two aspheric monofocal intraocular lens models

CLINICAL RELEVANCE

It is important to distinguish between visual acuity, optical quality and quality of vision when outcomes obtained with intraocular lenses are evaluated. These parameters, that includeobjective and subjective tests, should be assessed to obtain results that are not biased.

BACKGROUND

To assess the difference in visual and optical quality between two monofocal intraocular lens models.

METHODS

: This was a prospective, parallel and randomised clinical study conducted at Miranza IOA, a private clinic in Madrid, Spain. Sixty patients were implanted bilaterally, 30 per group, with two aspheric IOLs with induced spherical aberration of -0.27 μm for Group A and -0.20 μm for Group B. Visual outcomes obtained at 1 and 3 months after surgery included both uncorrected (UCVA) and corrected monocular distance visual acuity (DCVA), objective scattering index (OSI), modulation transfer function (MTF) cut-off, Strehl Ratio (SR), contrast sensitivity defocus curve (CSDC), intraocular lens spherical aberration (SA), and longitudinal chromatic aberration of the eye. Activity limitations in daily life were assessed using CatQuest-9SF questionnaire.

RESULTS

There were statistically significant differences for DCVA (0.04 LogMAR; p = .008) and SR (0.03; p = .003) between groups. Outcomes related to CSDC showed statistically significant differences for vergences between -0.50 D and +1.00 D (3 mm pupil) and for vergences of 0.00 D and +0.50 D (4.5 mm pupil) between groups. Overall, Group A showed better results regarding visual and optical quality, including a lower longitudinal chromatic aberration result in comparison to Group B. Patient satisfaction evaluated with CatQuest-9SF showed that Group A achieved better outcomes, although the differences were statistically significant only for the 'Reading text on television' item (p = 0.027).

CONCLUSIONS

Both intraocular lens models showed excellent quantity of vision, optical and visual quality as well as high patient satisfaction. Despite this, the the Group A model provided slightly better outcomes than the Group B model.

Defocus curves: Focusing on factors influencing assessment

ABSTRACT

Defocus curve assessment is used to emulate defocus over a range of distances and is a valuable tool that is used to differentiate the performance of presbyopia-correcting intraocular lenses. However, defocus curves are limited by a lack of standardization, and multiple factors can impact their generation and interpretation. This review discusses key factors that influence the assessment of defocus curves, including pupil size, level of contrast, sphere versus cylinder defocus, viewing distance, monocular versus binocular assessment, use of Snellen versus logarithm of the minimum angle of resolution charts, and diopter range and step size. There are also different methods to analyze defocus curves, including the direct comparison method, range-of-focus analysis, and area under the curve analysis, which can impact result interpretation. A good understanding of these factors and standardization of the methodology are important to ensure optimal cross-study comparisons.

Three-dimensional topographic changes of anterior chamber depth following phacoemulsification with intraocular lens implantation in cataract patients

PURPOSE

To investigate the three-dimensional topographic changes of anterior chamber depth (ACD) following cataract surgery.

METHODS

Seventy-eight eyes with age-related cataract undergoing phacoemulsification and intraocular lens (IOL) implantation were retrospectively enrolled. Participants were evaluated with Pentacam for ACD topography before and approximately four weeks after the surgery. The absolute changes of ACD (AACD) and the relative changes of ACD (RACD) topography were calculated, and three-dimensional topographic contours were plotted. The influence of age, gender, distance to corneal apex (DCA), temporal-nasal and superior-inferior on AACD and RACD was analyzed.

RESULTS

Both AACD and RACD were negatively correlated with the DCA (p < 0.001; p < 0.001) and positively correlated with the age at all DCA (p < 0.05 for all the analyses). Significantly greater AACD and RACD were observed in female subjects (p < 0.05, respectively, at all DCA). AACD was significantly larger in the temporal compared with the nasal region (p < 0.001) and at the superior compared with the inferior region (p < 0.001), but not RACD. Subgroup analysis indicated that the significant difference of the AACD between the temporal and nasal regions was manifested at the DCA of more than 6 mm (p < 0.001), and the difference between the superior and inferior regions was observed at 2 mm DCA for both AACD (p < 0.001) and RACD (p = 0.001).

CONCLUSIONS

We depicted the topographic changes of ACD following cataract surgery and found that it was significantly influenced by age, gender, DCA and quadrant location. The research provided the basis for including postoperative ACD topography prediction before cataract surgery in the future.

Comparison of an aspheric monofocal intraocular lens with the new generation monofocal lens using defocus curve

Purpose:

The aim of this study was to compare the visual outcomes of two monofocal intraocular lenses (IOLs), with emphasis on the defocus curve.

Methods:

A total of 116 consecutive eyes with cataract, undergoing phacoemulsification with IOL implantation were included in the observational case series, and divided into two groups. 71 eyes were implanted with Tecnis Eyhance and 45 with Tecnis 1 monofocal IOL. Eyes with ocular comorbidities, previous ocular surgeries and corneal astigmatism >1 Diopters (D) were excluded from the study. Complete ophthalmic evaluation including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), corrected intermediate visual acuity (CIVA), uncorrected visual acuity (UNVA), corrected near visual acuity (CNVA) was noted and defocus levels ranging from - 4.00 D to + 1.00 D were plotted postoperatively in both groups.

Results:

Uncorrected intermediate visual acuity (UIVA) and uncorrected near visual acuity (UNVA) was significantly better in Tecnis Eyhance group compared to Tecnis 1 monofocal. Both the IOLs have similar performance for distance vision but visual acuity at intermediate and near is significantly better with Tecnis Eyhance compared to Tecnis 1 piece IOL.

Conclusion:

Tecnis Eyhance IOL with its better defocus curve, not only provides good distance, but intermediate vision as well. With significantly better visual acuity across the range of near and intermediate vision, Tecnis Eyhance IOL can prove to be a viable and reasonable option for patients who are more dependent on intermediate vision in daily activities.

Quantitative Assessment of the Pupil: An Underrecognized Yet Important Factor Related to Orbital Blowout Fracture Repair

PURPOSE

To investigate dynamic pupil changes after orbital blowout fracture repair. To compare postoperative changes in under photopic and mesopic pupil size and center position after orbital blowout fracture repair surgery.

METHODS

The study evaluated 19 eyes. Pupils were imaged for pupil size and center position before and 3 months after orbital blowout fracture repair surgery. Pupil size changes were measured, and the correlation between preoperative and postoperative pupil centroid shift was evaluated.

RESULTS

After repair, operative eyes exhibited a growth of 9.3% ± 8.6% in pupil size, and contralateral eyes showed a growth of 8.6% ± 8.2% (P = 0.011, P = 0.007). Similar findings were noted in mesopic conditions. Under mesopic conditions, the pupil of operative eyes in medial orbital wall fracture deviated 0.030 ± 0.019 mm towards the nasal side along the X-axis (P = 0.031). The postoperative orbital floor fracture group demonstrated statistical significance at a spatial frequency of 5 (P = 0.041).

CONCLUSIONS

Orbital blowout fracture repair surgery affects pupil size and center position.

Comprehensive Evaluation of Retinal Image Quality in Comparing Different Aspheric to Spherical Intraocular Lens Implants

Purpose: To compare the visual and optical quality of eyes implanted with three aspheric versus two spherical intraocular lenses (IOL) after cataract surgery. Methods: This prospective comparative study included 349 eyes of 349 patients with age-related cataract and undergone uneventful phacoemulsification. Implanted posterior monofocal IOLs have an aspheric optic (Tecnis ZCB00 [Johnson & Johnson Vision], Acrysof IQ SN60WF [Alcon], Akreos AO [Bausch & Lomb]) or a spherical optic (Akreos [Bausch & Lomb], Sensar AR40e [Johnson & Johnson Vision]). Postoperatively, objective optical quality parameters were performed using an Optical Quality Analysis System II (Visiometrics), and wave-front aberrations were assessed using a KR-1W aberrometer (Topcon). Meanwhile, subjective visual acuity was performed using a logarithm of the minimum angle of resolution chart at 3 months after cataract surgery. Results: Statistical significant differences (P < .05) across all groups were found regarding intraocular and total ocular spherical aberration (SA) at 4.0 mm and 6.0 mm pupil diameter and total high-order aberration (tHOA) at 6.0 mm pupil diameter. Furthermore, differences among the evaluated groups were observed regarding several objective parameters such as objective scatter index (OSI), modulation transfer function cutoff (MTF cutoff), Strehl ratio (SR) at two dimensions and contrast visual acuity (OV) at three contrast levels. Conclusions: The present results reflect the optical characteristics of IOL in vivo. The scattering light and high-order aberration may be the main reasons for the degradation of retinal imaging quality in comparing different aspheric to spherical IOL implants.

Objective Verification of Physiologic Changes during Accommodation under Binocular, Monocular, and Pinhole Conditions

BACKGROUND

To objectively investigate accommodative response to various refractive stimuli in subjects with normal accommodation.

METHODS

This prospective, non-randomized clinical trial included 64 eyes of 32 subjects with a mean spherical equivalent -1.4 diopters (D). We evaluated changes in accommodative power, pupil diameter, astigmatic value, and axis when visual stimuli were applied to binocular, monocular (dominant eye, non-dominant eye, ipsilateral, and contralateral), and pinhole conditions. Visual stimuli were given at 0.25 D (4 m), 2 D (50 cm), 3 D (33 cm), and 4 D (25 cm) and accommodative response was evaluated using open view binocular autorefractor/keratometer.

RESULTS

The accommodative response to binocular stimulus was 90.9% of the actual refractive stimulus, while that of the monocular stimulus was 84.6%. The binocular stimulus induced a smaller pupil diameter than did the monocular stimulus. There was no difference in accommodative response between the dominant eye and non-dominant eye or between ipsilateral and contralateral stimuli. As the refractive stimuli became stronger, the absolute astigmatic value increased and the direction of the astigmatism axis became more horizontal. Pinhole glasses required 10%-15% less accommodative power compared with the monocular condition.

CONCLUSION

Binocular stimuli enable more precise and effective accommodation than do monocular stimuli. Accommodative response is composed of 90% true accommodation and 10% pseudo-accommodation, and the refractive stimulus in one eye affects the contralateral eye to the same extent. This should be taken into account when developing guidelines for wearing smart glasses while driving, as visual stimulation is applied to only one eye, but far distance attention is constantly needed.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03557346.

Evaluation of Optical Quality: Ocular Scattering and Aberrations in Eyes Implanted with Diffractive Multifocal or Monofocal Intraocular Lenses

PURPOSE

To compare objective optical quality, ocular scattering and aberrations of eyes implanted with an aspheric monofocal intraocular lens (IOL) or an aspheric apodized diffractive multifocal IOL three months after surgery.

METHODS

Prospective consecutive nonrandomized comparative cohort study. A total of 80 eyes from 57 cataract patients were bilaterally or unilaterally implanted with monofocal (AcrySof IQ SN60WF) or multifocal (AcrySof IQ ReSTOR SN6AD1) IOLs. Respectively, 40 eyes of 27 patients were implanted with monofocal IOLs, and 40 eyes of 30 patients were implanted with multifocal IOLs. Ocular high-order aberration (HOA) values were obtained using Hartmann-Shack aberrometer; objective scatter index (OSI), modulation transfer function (MTF) cutoff, Strehl ratio (SR), and contrast visual acuity OV at 100%, 20%, and 9% were measured using Objective Quality Analysis System II (OQAS II).

RESULTS

Ocular aberrations performed similar in both groups (p > 0.05). However, significantly higher values of OSI and lower values of MTF cutoff, SR and OV were found in the SN6AD1 group (p < 0.05).

CONCLUSIONS

Both ocular scattering and wave-front aberrations play essential role in retinal image quality, which may be overestimated when only aberrations were taken into account. Combining the effect of ocular scattering with HOA will result in a more accurate assessment of the visual and optical quality.

Reliability of Ocular Aberration Measurements in Children with Moderate and Low Myopia under Scotopic Conditions

Purpose

To investigate the reliability of ocular aberration measurement in myopic children under scotopic conditions and to validate the mathematical Zernike pupil scaling-down technique.

Methods

Ocular aberrations of 45 myopic children were examined under scotopic conditions via iTrace aberrometer. The intra- and intersession repeatability was evaluated for both the measured values with the true pupil sizes and the estimated ones that were determined by scaling down the pupil sizes to the largest integer value across all measurements.

Results

The intra- and intersession difference of clinically measured aberration was generally insignificant, and the ICCs for each aberration component exhibited good to excellent reliability (ICCs > 0.4). Similar results were found for the estimated aberration using the scaling-down technique. Although the majority of the estimated Zernike components were comparable with the corresponding measured one, the estimated values of defocus, coma, and the corresponding total aberrations were found significantly smaller than the measured values (all P < 0.01).

Conclusions

The ocular aberration measurements in myopic children under the circumstances described are reliable. The scaling-down technique is a useful option for comparing the results obtained from different pupil sizes, but the estimated Zernike coefficients were not always comparable with the corresponding measured values.

Clinical Outcomes Following Implantation of Diffractive Multifocal Intraocular Lenses With Varying Add Powers

PURPOSE

To compare clinical outcomes after implantation of TECNIS diffractive multifocal intraocular lenses (IOLs) with different add powers.

DESIGN

Prospective, comparative, interventional case series.

METHODS

Subjects underwent cataract extraction and diffractive multifocal IOL implant. Subjects had an additional add power of +2.75 diopters (D) (Group 1, 23 eyes), +3.25 D (Group 2, 21 eyes), or +4.00 D (Group 3, 21 eyes). Evaluations were performed 1 and 3 months following cataract surgery, including measurement of monocular uncorrected distance visual acuity (UDVA), refractive error (manifest refraction [MR]), and monocular uncorrected near visual acuity (UNVA) at 33, 40, and 50 cm. At 3 months, internal aberrations and contrast sensitivity were evaluated and subjects completed a questionnaire on outcomes satisfaction, visual symptoms, and spectacle use.

RESULTS

Sixty-five eyes (43 subjects) were included. After surgery, no significant differences between groups were observed in UDVA and MR values. UNVA at 33 cm was best in Group 3 (1 month: P = .032; 3 months: P = .031). Three months after surgery, UNVA was best in Group 1 at 50 cm (P = .017). No significant differences in internal aberration and contrast sensitivity were observed between groups and surgical satisfaction was worst in Group 3 (P = .001). A total of 87.0%, 85.7%, and 76.9% had spectacle independence in Groups 1, 2, and 3, respectively (P = .080).

CONCLUSIONS

TECNIS diffractive multifocal IOLs with lower add powers provide good vision over longer working distances and excellent distant vision. Subjects with lower add power had greater satisfaction, more spectacle independence, and fewer visual symptoms than those with +4.00 D add.

Effect of pupil size on higher-order aberrations in high-myopic pseudophakic eyes with posterior staphyloma

PURPOSE

To evaluate the effect of pupil size on higher-order aberrations (HOAs) in high-myopic pseudophakic eyes with posterior staphyloma using KR-1W aberrometer.

METHODS

Forty eyes of 40 high-myopic cataract patients with posterior staphyloma and 20 eyes of 20 age-related cataract patients with normal axial length were recruited. At 1 month after phacoemulsification and intraocular lens implantation, ocular and internal HOAs as well as the visual quality data in the two groups were evaluated with KR-1W analyzer before and after mydriasis.

RESULTS

Compared with normal axial length eyes, high-myopic pseudophakic eyes with posterior staphyloma had significantly lower values of internal coma both under 4-mm and 6-mm pupil sizes (P<0.001 and 0.020), as well as internal total HOAs (P<0.001) and third-order aberrations at 6-mm pupil size (P=0.018). Statistically significant differences were also found in the variation from 4- to 6-mm pupil sizes for internal coma (P=0.001), internal third-order aberrations (P=0.009), internal total HOAs (P=0.007), and ocular coma aberrations (P=0.006) between two groups. After mydriasis, Strehl ratio increased significantly in high-myopic eyes, whereas decreased slightly in normal axial length eyes (P=0.032 when compared with the variation between the two groups). Statistically significant differences were also found for the variation of modulation transfer functions (MTFs) at frequencies of 15, 30, 45, and 60 cycles/degree between the two groups (P=0.002, 0.002, 0.004, and 0.010, respectively).

CONCLUSIONS

High-myopic pseudophakic eyes with posterior staphyloma had significantly lower internal coma and less coma variations during mydriasis.

Change in efficiency of aspheric intraocular lenses based on pupil diameter

PURPOSE

To measure the effect of spherical aberration correction by aspheric intraocular lenses (IOLs) based on pupil diameter, and to determine the minimum pupil diameter for each aspheric IOL.

DESIGN

Retrospective cross-sectional study.

METHODS

Eight-six patients (169 eyes) who were implanted with a HOYA AF-1 NY-60 (HOYA Corporation) or Tecnis ZCB00 1-piece IOL (Abbott Medical Optics Inc) were enrolled. Ocular, corneal, and internal spherical aberrations were measured at the 1-month postoperative visit using the Wavefront Analyzer KR-1W (Topcon). Minimum pupil diameter, which is required for each aspheric IOL to be effective, was calculated using a regression equation.

RESULTS

The mean value of internal spherical aberration of the Tecnis ZCB00 group (-0.09 ± 0.094 μm) was lower than that of the HOYA NY-60 group (-0.05 ± 0.072 μm) (P = .005). The original negative spherical aberrations of the HOYA NY-60 (-0.18 μm) were measured at a pupil diameter of 5.6 mm, and for the Tecnis ZCB00 (-0.27 μm) at a pupil diameter of 6.1 mm. The aspheric IOL efficiency dropped to 0% when the pupil diameter was 3.47 mm for the Tecnis ZCB00 group and 3.71 mm for the HOYA NY-60 group.

CONCLUSIONS

When the pupil diameters of patients are smaller than 3.4 mm for the Tecnis ZCB00 and 3.7 mm for the HOYA NY-60, the spherical aberration correction using these aspheric IOLs seems to be ineffective. Approximately 10% of the eyes showed smaller pupil size than the minimum effective diameter under mesopic conditions.

Visual performance of the Tecnis one-piece lens ZCB00

Synopsis

The aspheric, one-piece design of the Tecnis^® ZCB00 intraocular lens provided higher mesopic contrast sensitivity and relatively constant refraction at different pupil sizes compared to the Sensar^® AR40e.

Purpose

Comparing the impact on functional vision of the aspheric Tecnis^® ZCB00 one-piece lens compared to the spherical Sensar^® AR40e three-piece lens.

Setting

National Eye Hospital, Cairo, Egypt.

Methods

In this prospective study, we implanted 32 Tecnis ZCB00 (Abbott Medical Optics, Santa Ana, CA) and 30 Sensar AR40e (Pharamacia and Upjohn LLC, North Peapack, NJ) lenses. Twenty-three patients in the ZCB00 group and 13 patients in the AR40e group provided reliable, reproducible data, and were therefore included in the statistical analysis. After 8 weeks, we measured photopic contrast sensitivity (PCS) at 85 cd/m² and mesopic contrast sensitivity (MCS) at 5 cd/m². Uncorrected and best-corrected visual acuity were measured. Myopic shift was analyzed by comparing the manifest refraction spherical equivalent at 3 days and 8 weeks after surgery in the normal and dilated pupil.

Results

The Tecnis ZCB00 group showed significantly better MCS than the Sensar AR40e group at a spatial frequency of six cycles per degree (cpd) (P = 0.037), but not at 3, 12, or 18 cpd (P = 0.299, P = 0.226, and P = 0.396, respectively). There were no significant differences between groups in corrected distance visual acuity (P = 0.175) or PCS at 3, 6, 12, or 18 cpd spatial frequencies (P = 0.440, P = 0.176, P = 0.365, and P = 0.251, respectively). The ZCB00 group showed less myopic shift in normal and dilated pupils between 3 days and 8 weeks after surgery compared to the AR40e group, but this difference was not significant.

Conclusion

The Tecnis one-piece ZCB00 provided higher MCS at moderate spatial frequency than the three-piece Sensar AR40e, and was associated with relatively constant refraction at different pupil sizes.

Translational research in retinology

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