Outcomes of Corneal Spherical Aberration-Guided Cataract Surgery Measured by the OPD-Scan

PURPOSE: To determine based on preoperative corneal spherical aberration, the practicality of targeting zero total ocular postoperative spherical aberration when selecting an aspheric intraocular lens (IOL). METHODS: Consecutive cataract patients were selected to receive an aspheric IOL based on corneal spherical aberration. A target of zero postoperative total spherical aberration Z(4,0) was calculated. One of three IOLs was chosen, based on the corneal spherical aberration Z(4,0) measurement at the 6-mm optical zone. The IOL was selected based on the summation of the corneal spherical aberration and the aspheric value of the prolate optic. The intention was an absolute value of zero total spherical aberration. Statistical analysis of the postoperative total ocular wavefront profile was performed to assess the accuracy of aspheric IOL selection. RESULTS: Forty eyes of 40 patients were available for postoperative assessment. The Tecnis Z9003 (Abbott Medical Optics) was implanted in 25 eyes with a preoperative corneal spherical aberration of +0.311±0.054 μm, the AcrySof IQ (Alcon Laboratories Inc) in 13 eyes (+0.188±0.034 μm), and the SofPort-Advanced Optic with Violet Shield (Bausch & Lomb) was implanted in 2 eyes (+0.0915 μm). Total postoperative ocular spherical aberration for the entire group measured +0.019±0.051 μm (Tecnis: +0.024±0.058 μm; AcrySof IQ: +0.010±0.035 μm; and SofPort AOV: +0.037 μm). Mean absolute predictive error, for the entire group, measured +0.025±0.020 μm. CONCLUSIONS: Skiascopy-derived total wavefront measurement of spherical aberration is a reproducible method of aspheric IOL selection and permits more precise control of total ocular spherical aberration.