Duration 5min, Q&A 3min
Wavefront Analysis of Aspheric Versus Spherical Intraocular Lenses Implantation in Cataract Surgery: A Systematic Review with Meta-Analysis
Implantation of aspheric intraocular lenses in cataract surgery results in improved contrast sensitivity compared to spherical intraocular lenses under photopic and in a greater extent under mesopic light conditions. We conducted this meta-analysis study to evaluate the influence of the implantation of aspheric intraocular lenses compared to spherical IOL on wavefront properties in a pseudophakic eye.
Systematic Review of randomized controlled trials with meta-analysis
Peer-reviewed literature was systematically searched in Medline, EMBASE, Web of Science, BIOSIS and the Cochrane library according to the Cochrane Collaboration method to identify randomized controlled trials on the subject. The inclusion criteria were randomized controlled trials on cataract surgery comparing the use of aspheric versus spherical monofocal IOL implantation that assessed visual acuity, contrast sensitivity or quality of vision. As secondary outcome ocular wavefront analysis was summarized. The data were grouped for different pupil sizes and for the different aspheric IOL models evaluating higher-order aberrations, spherical aberration, coma and trefoil described in Zernike polynomials. Effects were calculated as standardized mean differences in Hedges' g and were pooled using random effect models.
Results and Conclusion
Thirty-four studies out of forty-three published studies assessing visual acuity, contrast sensitivity or quality of vision provided data for wavefront analysis. Aspheric IOL implantation decreases ocular spherical aberration in comparison to spherical IOL implantation (pupil size 4mm: ES (effect size)= -1.78 [-2.40; -1.15] 95% confidential interval, pupil size 5mm: ES= -2.19 [-2.69;-1.69], pupil size 6mm: ES= -2.03 [-2.46;-1.59]). Ocular coma was slightly smaller after aspheric IOL implantation for a pupil size of 6mm (ES=-0.24 [-0.40;-0.08]), while no effect was found for 4mm or 5mm. For ocular trefoil measurements, a significant effect was calculated only for a pupil size of 4mm (ES=-0.47 [-0.87;-0.07]), but not for 5mm or 6mm. Higher-order aberrations are smaller after aspheric IOL implantation (pupil size 4mm: ES=-0.61 [-1.10; -0.13], pupil size 5mm: ES=-0.63 [-0.93; -0.34], pupil size 6mm: ES=-1.12 [-1.47;-0.77]). A difference between the aspheric IOL models was not found.
Aspheric monofocal IOL implantation results in less ocular spherical aberration and less ocular higher-order aberrations compared to spherical IOLs. This might explain the better performance in contrast sensitivity of aspheric compared to spherical IOLs.
[ Keyword ]
cataract surgery / aspheric / IOL / intraocular lens / monofocal
[ Conflict of Interest ]