Clinical Results after Implantation of a Spherical Aberration-Free Intraocular Lens: Effect of Contrast Sensitivity and Wavefront Aberration – A Clinical Comparative Study

PURPOSE: To compare the clinical results of the spherical aberration-free Akreos AO (Bausch & Lomb) with the Akreos Adapt (Bausch & Lomb), the parent model of spherical optic design. METHODS: Fifty patients (100 eyes) were randomly assigned to bilaterally receive Akreos AO or Akreos Adapt intraocular lenses (IOLs) after phacoemulsification. At 6 months postoperatively, best-corrected contrast sensitivities were determined at 3, 4.8, 7.5, 12 and 19 cycles per degree using a Visual Capacity Analyzer (L2 Informatique) under mesopic (5 cd/m(2)) and photopic (100 cd/m(2)) conditions with undilated pupils. Wavefront analysis of total aberration was performed with the WaveScan WaveFront System (Advanced Medical Optics VISX). RESULTS: Postoperative contrast sensitivities were not statistically different under mesopic and photopic conditions. On the other hand, fourth-order spherical aberration was lower in the AO group than the Adapt group with only a marginal difference (p = 0.048). Other higher-order aberrations such as coma and trefoil were not significantly different between the two groups (p = 0.657, 0.614). The questionnaire on subjective visual quality in terms of glare disability, distant vision and night driving did not reveal an improved visual function in the AO group. CONCLUSION: The spherical aberration-free Akreos AO IOL did not show improved visual quality compared with its spherical counterpart.