PURPOSE: There have been few studies which compared aspherical and spherical intraocular lenses (IOLs) of same material and platform in bilateral cataract cases. We performed an intraindividual comparison of ocular aberration and scotopic, mesopic, and photopic contrast sensitivity with aspherical and spherical IOLs, using the same IOL material and platform manufactured by the same company. DESIGN: Prospective, randomized, controlled study. PARTICIPANTS: Eighty-two eyes of 41 patients undergoing bilateral cataract surgery. METHODS: One eye of a patient was assigned to acrylic foldable aspherical IOL (Tecnis ZA9003, Advanced Medical Optics), and the contralateral eye was allocated to acrylic foldable spherical IOL (AR40e, Advanced Medical Optics). All patients were examined at 2 days, 1 week, and 1 month postoperatively. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), contrast sensitivity under scotopic (15 lux), mesopic (70 lux), and photopic (180 lux) conditions, corneal and ocular wavefront aberrations, anterior chamber depth, amount of IOL decentration and tilt, pupil diameter under scotopic (3 lux) and photopic (250 lux) conditions, area of anterior capsule opening, degree of posterior capsule opacification, and all-distance visual acuity. RESULTS: There was no significant difference between IOLs in BCVA, anterior chamber depth, amount of IOL decentration and tilt, pupil diameter, area of anterior capsule opening, and degree of posterior capsule opacification. In corneal wavefront aberrations, there was no difference in 3rd-, 4th-, and total higher-order root-mean-square (RMS). In ocular wavefront aberration, aspherical IOL showed significantly lower 4th-order (P<0.001) and total higher-order RMS (P<0.001) than spherical IOL, but not in 3rd-order RMS (P = 0.103). Contrast sensitivity under scotopic conditions was significantly better with aspherical IOL than with spherical IOL at 3 (P = 0.0015), 6 (P = 0.0192), and 12 cycles per degree (P = 0.0315). Contrast sensitivity under mesopic and photopic conditions was not significantly different between IOLs. There was no between-group difference in visual acuity at 0.3, 0.5, 0.7, 1.0, or 5.0 meters measured with full distance correction. CONCLUSIONS:Acrylic foldable aspherical IOL (Tecnis ZA9003) yielded significantly lower ocular wavefront aberration and better contrast sensitivity under scotopic condition without compromising depth of focus. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.
RCT Entities:
PURPOSE: There have been few studies which compared aspherical and spherical intraocular lenses (IOLs) of same material and platform in bilateral cataract cases. We performed an intraindividual comparison of ocular aberration and scotopic, mesopic, and photopic contrast sensitivity with aspherical and spherical IOLs, using the same IOL material and platform manufactured by the same company. DESIGN: Prospective, randomized, controlled study. PARTICIPANTS: Eighty-two eyes of 41 patients undergoing bilateral cataract surgery. METHODS: One eye of a patient was assigned to acrylic foldable aspherical IOL (Tecnis ZA9003, Advanced Medical Optics), and the contralateral eye was allocated to acrylic foldable spherical IOL (AR40e, Advanced Medical Optics). All patients were examined at 2 days, 1 week, and 1 month postoperatively. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA), contrast sensitivity under scotopic (15 lux), mesopic (70 lux), and photopic (180 lux) conditions, corneal and ocular wavefront aberrations, anterior chamber depth, amount of IOL decentration and tilt, pupil diameter under scotopic (3 lux) and photopic (250 lux) conditions, area of anterior capsule opening, degree of posterior capsule opacification, and all-distance visual acuity. RESULTS: There was no significant difference between IOLs in BCVA, anterior chamber depth, amount of IOL decentration and tilt, pupil diameter, area of anterior capsule opening, and degree of posterior capsule opacification. In corneal wavefront aberrations, there was no difference in 3rd-, 4th-, and total higher-order root-mean-square (RMS). In ocular wavefront aberration, aspherical IOL showed significantly lower 4th-order (P<0.001) and total higher-order RMS (P<0.001) than spherical IOL, but not in 3rd-order RMS (P = 0.103). Contrast sensitivity under scotopic conditions was significantly better with aspherical IOL than with spherical IOL at 3 (P = 0.0015), 6 (P = 0.0192), and 12 cycles per degree (P = 0.0315). Contrast sensitivity under mesopic and photopic conditions was not significantly different between IOLs. There was no between-group difference in visual acuity at 0.3, 0.5, 0.7, 1.0, or 5.0 meters measured with full distance correction. CONCLUSIONS: Acrylic foldable aspherical IOL (Tecnis ZA9003) yielded significantly lower ocular wavefront aberration and better contrast sensitivity under scotopic condition without compromising depth of focus. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.