Wavefront Analysis And Optical Performance Of A Novel Aspheric Monofocal Intraocular Lens With A Higher Order Aspheric Coefficient Designed To Improve Depth Of Focus.
Published 2024 - 42nd Congress of the ESCRS
Reference: PP07.04 | Type: Free paper | DOI: 10.82333/3jxj-7t20
Authors: Marcela Feltrin De Barros* 1 , Raman Bedi 2 , Marcony Santhiago 3 , Karolinne Maia Rocha 4
1Ophthalmology,Medical University of South Carolin,CHARLESTON,United States, 2IrisARC,Chandigarh,India, 3Ophthalmology,Universidade de Sao Paulo,Sao Paulo,Brazil, 4Medical University of South Carolin,CHARLESTON,United States
Purpose
To evaluate the visual function, depth of focus curve, automated refraction, and in vivo wavefront analysis of a new monofocal intraocular lens designed to extend the depth of focus.
Setting
Medical University of South Carolina, Storm Eye Institute, Charleston, SC.
Methods
This prospective observational study included eyes undergoing cataract surgery and implantation of a monofocal IOL with a controlled change in posterior curvature to increase higher-order aspheric coefficient (Envista Aspire, B&L). Corneal asphericity (Q value) and natural pupil size were measured preoperatively. Postoperative assessment included refractive outcomes, manifest refraction spherical equivalent (MrxSE), UDVA, CDVA, DCIVA and DCNVA, subjective depth of focus (DoFs) curves, and pupil size. Lower-order aberrations (LOAs) and higher-order aberrations (HOAs) were obtained from three different aberrometers (double-pass skiascopy, ray-tracing, and combined Scheimpflug and Hartman-Shack devices) at 1-3 months postoperatively
Results
Mean UDVA was 0.015 ± 0.02 logMAR, DCIVA was 0.22 ± 0.206 logMAR and DCNVA was 0.34 ± 0.21 logMAR. Wavefront analysis for a 4.5 mm pupil size revealed average 4th-order spherical aberration (SA) and coma of 0.05 ± 0.05 µm and 0.15 ± 0.05 µm, respectively, using a combined Scheimpflug and Hartman-Shack device, and 0.03 ± 0.08 µm and 0.13 ± 0.11 µm with double pass skiascopy. Subjective DoFs ranged from 2.00 to 2.50 D with a mean value of 2.30 ± 0.27 D for functional vision of 20/40 or better. Mean MrxSE was 0.06 ± 0.36D, compared to -0.02 ± 0.48D (p=0.58) with automated refraction measured with double pass skiascopy, 0.05 ± 0.46D (p=0.94) with ray-tracing, and -0.18 ± 0.45D (p=0.04) using the combined Scheimpflug and Hartman-Shack device.
Conclusions
In vivo wavefront analysis of a monofocal intraocular lens with increased higher-order aspheric coefficient showed no induction of total 4th-order spherical aberration with different aberrometers. Compared to manifest refraction, automated refraction spherical equivalent using the combined Scheimpflug and Hartman-Shack device is slightly more myopic than the other two means spherical equivalent wavefront devices. Refractive outcomes revealed enhanced depth of focus with up to 2.00 D of functional vision of 20/40 or better