Evaluation of the consistency of total spherical aberration before and after aspherical intraocular lens implantation.

PURPOSE: To analyze the consistency between preoperatively estimated and postoperatively measured total spherical aberration and to evaluate the feasibility of personalized selection of an aspherical intraocular lens (IOL) based on the corneal spherical aberration measured by the Scheimpflug photography system (Pentacam). METHODS: A total of 47 patients (82 eyes) with age-related cataract received a comprehensive ophthalmologic examination. Corneal spherical aberration was measured by using the Scheimpflug photography system. Patients with corneal spherical aberration < or = 0.3 microm were implanted with a zero-spherical aberration advanced optics (AO) aspherical intraocular lens and those with corneal spherical aberration > 0.3 microm received a Tecnis ZA9003 aspherical lens (-0.27 microm spherical aberration). Preoperative total remnant spherical aberration was estimated and actual total spherical aberration was measured 3 months postoperatively. The consistency between preoperative and postoperative spherical aberration was analyzed by t-test, correlation analysis, and Blant-Altman plots. RESULTS: The estimated and measured values of total spherical aberration were (0.189 +/- 0.151) microm and (0.141 +/- 0.131) microm, with a statistical difference (t = 5.347, P < 0.01). For 45 eyes implanted with AO lenses, preoperatively estimated and postoperatively measured total spherical aberration were (0.268 +/- 0.137) microm and (0.214 +/- 0.103) microm. For 37 eyes implanted with Tecnis ZA9003, preoperative estimate of total spherical aberration was (0.092 +/- 0.103) microm and postoperative measured value was (0.054 +/- 0.106) microm. Statistical significance was noted, as was a positive linear correlation between preoperative and postoperative values (gamma = 0.846, P < 0.01). Bland-Altman analysis showed high consistency between the estimated and measured spherical aberration. CONCLUSION: The estimated total spherical aberration measured preoperatively differed from the value measured postoperatively, but the two values showed good agreement. It is clinically feasible to conduct personalized selection of aspherical IOL based on Scheimpflug photography system (Pentacam) to measure corneal spherical aberration.