Effect of intraocular lens material on optical quality of ...

Effect of intraocular lens material on optical quality of ...

Clinico-pathological results of optical quality with different acrylic materials Mayank A. Nanavaty, DO, MRCOphth, MRCS(Ed) David J. Spalton, FRCP, FRCS, FRCOphth James F. Boyce, PhD Thomas J. T. P. Van den berg, PhD None of the authors have any financial or proprietary interest St. Thomas Hospital, London Introduction Optical quality of vision is dependent on aberrations, PSF, MTF and ocular scatter apart from visual acuity. There is paucity of information on influence of IOL material on optical quality One published study objectively quantifying the relationship between IOL material and ocular scatter

Tanaka et al. Limitation of Scheimpflug videophotography system in quantifying posterior capsule opacification after intraocular lens implantation. Am J Ophthalmol 2004 Apr;137(4):732-5. Aim To analyze the effect of IOL material on optical quality in eyes with clear posterior capsules using the asymmetric double pass technique with Optical Quality Analysis System (OQAS II) Methods Retrospective, non-randomized, observational study Patients with clear posterior capsule were recruited from the follow up of two different ongoing prospective, randomized fellow eye controlled studies comparing Hydrophilic - AcriSmart 36A & Akreos MI60 Hydrophobic - AcrySof IQ & AcrySof Natural Single surgeon with standardized surgical technique

Eyes with clear capsule in central 4mm zone on POCOman analysis of digital retro-illumination images were recruited Hydrophilic IOLs AcriSmart 36A AcrySof IQ Hydrophobic IOLs Akreos MI60 AcrySof Natural Methods Data of: 100% & 9% LogMAR BCVA Entire eye aberrations at 4mm scan size 50% & 10% PSF, MTF and Strehl ratio after correcting LOA

was extracted for these eyes with clear posterior capsules Two 20D IOLs of each IOL type was sent for in-vitro analysis of light scatter Results 160 eyes of 80 patients were screened 71 eyes of 46 patients had clear capsules 58 were white Caucasians, 9 Afro-Caribbean, 2 Indians, 2 Mongolians Postoperative duration (days) IOL power (diopters) Postoperative Spherical Equivalent (Diopters) Hydrophilic IOLs [mean standard deviation (95% confidence interval)] (n=28)

Hydrophobic IOLs [mean standard deviation (95% confidence interval)] (n=43) p values* 127.7 41.2 (122.3, 133.0) 342.6 65.6 (335.7, 349.4) 0.000 19.75 5.20 (19.07, 20.43) -0.19 0.60 (-0.27, -0.11) 21.13 4.02

(20.71, 21.55) -0.10 0.59 (-0.16, -0.04) 0.240 0.534 *Unpaired two tailed t test, Statistically significant, p < 0.05, BCVA = Best corrected visual acuity, No significant difference in aberrations at 4 mm scan size except Zernickes polynomial 4 (defocus) Best corrected visual acuity p = 0.000 0.6 LogMAR 0.4 p = 0.127 0.2

0.0 100% LogMAR 9% LogMAR -0.2 Hydrophilic Acrylic Hydrophobic Acrylic OQAS II measurements PSF measurements Optical Quality analysis system (OQAS II) p = 0.005 PSF Value (arc min) 40

30 20 10 0 Measurements done after correcting sphere and cylinder p = 0.008 50% PSF 10% PSF Hydrophilic Acrylic Hydrophobic Acrylic There was no significant difference in MTF and Strehl ratio between to the two IOL groups

In-vitro assessment of scatter 2 cataract (10x) log straylight parameter 1.5 good 77 old eye (3x) 1 hydrophilic young eye (1x) hydrophobic 0.5 young eyes good 77y old cataract (10x)

0 -0.5 -1 -25 -20 -15 -10 -5 0 5 10

15 20 25 scatter angle (degrees) Although in-vitro scatter levels are low with acrylic IOLs, hydrophilic acrylic IOLs have more scatter than hydrophobic acrylic IOLs Conclusion IOL material has no effect on 100% BCVA, entire eye aberrations, MTF and Strehl ratio Hydrophilic Acrylic IOLs have reduced 9% LogMAR BCVA Ocular scatter is more with hydrophilic Acrylic IOLs This may be because of increased opalescence of the hydrophilic acrylic material due to more water content

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