[The influence of preoperative corneal spherical aberration on relatively personalized implantation of aspheric intraocular lens].

OBJECTIVE: To analysis the feasibility of selectively targeting zero total postoperative spherical aberration by selecting the best fit aspheric intraocular lens (IOL) based on preoperative corneal spherical aberration of patients. METHODS: It was a prospective case series study. The corneal spherical aberration (Z40) with 6 mm aperture of 57 eyes (46 patients) was measured with a iTrace Visual Function Analyzer 1 day before surgery, the target postoperative total spherical aberration was set at zero. Thus, for corneal spherical aberration<+0.100 microm, the Sofport Advanced Optic (AO)IOL(10 eyes) was selected; for corneal spherical aberration>+0.100 microm but if <+0.235 microm, the AcrySof IQ IOL (20 eyes) was selected; and for corneal spherical aberration>+0.235 microm, Tecnis ZA9003 IOL (27 eyes)was selected. Aspherical IOL was implanted after phacoemulsification through a clear-cornea, 3.2 mm incision without suture. Uncorrected visual acuity, best corrected visual acuity (BCVA), spherical aberration of the whole eye and internal optics (IOL) at 6 mm pupil diameter were examined at 3 months postoperatively. ANOVA and t-test were used to analyze the data at 3 months postoperatively. RESULTS: Total postoperative ocular spherical aberration at 6 mm pupil diameter for the entire population measured (0.015+/-0.056) microm [AO: (0.081+/-0.013) microm; IQ: (0.006+/-0.038) microm; Tecnis: (0.007+/-0.070) microm]. For the entire population, there was no significantly different between the predicted value and actual value of ocular spherical aberration at 6 mm pupil diameter: t=1.983, P=0.052 (AO:t=1.957, P=0.082; IQ: t=0.030, P=0.976; Tecnis: t=2.031, P=0.053). For the entire population, the predictive error measured (0.014+/-0.044) microm [AO: (0.006+/-0.012) microm; IQ: (-0.000+/-0.037) microm; Tecnis: (0.027+/-0.052) microm; F=2.626, P=0.082]. The postoperative visual activity was not significantly different among the three groups (P>0.05). CONCLUSION: Customized selection of aspheric IOL based on preoperative corneal spherical aberration of patients is feasible and produces satisfactory target postoperative total spherical aberration.