Postoperative wavefront analysis and contrast sensitivity of a multifocal apodized diffractive IOL (ReSTOR) and three monofocal IOLs

Abstract

Purpose: To compare visual acuity, total and high order wavefront aberrations (coma, spherical aberration, and other terms of high order aberration), and contrast sensitivity in 105 eyes implanted with 4 different types of intraocular lenses (IOLs) (1 multifocal apodized diffractive IOL and 3 monofocal IOLs).

Methods: A prospective study comparing four types of IOLs (Alcon ReSTOR [50 eyes], Alcon Acrysof MA30AC [20 eyes], Alcon Acrysof SA60AT [20 eyes], and Mediphacos Acqua IOL [15 eyes]) was carried out. All eyes were targeted for emmetropia. Complete ophthalmological examination, including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity (Pelli-Robson chart), and wavefront analysis, was performed 2 months postoperatively.

Results: All eyes in all groups had BSCVA > or = 20/32 postoperatively. Mean total aberration root-mean-square (RMS) values were: 0.72 +/- 0.25 microm (ReSTOR), 0.94 +/- 0.26 microm (MA30), 0.84 +/- 0.23 microm (SA60), and 2.04 +/- 0.77 microm (Acqua). Mean higher order aberration values were: 0.35 +/- 0.15 microm (ReSTOR), 0.41+/- 0.12 microm (MA30), 0.43 +/- 0.13 microm (SA60), and 0.85 +/- 0.50 microm (Acqua). The Acqua IOL showed statistically significant more total and higher order aberrations when compared with the other IOLs (P < .05). The ReSTOR IOL showed statistically significant less induction of spherical aberration when compared to the monofocal IOLs (P < .05). Mean contrast sensitivity values were: 1.64 +/- 0.08 (ReSTOR), 1.72 +/- 0.08 (MA30), 1.70 +/- 0.07 (SA60), and 1.65 +/- 0.11 (Acqua).

Conclusions: Different types of IOLs resulted in measurably different postoperative higher order aberration patterns. The multifocal apodized diffractive IOL (ReSTOR) induced significantly less spherical aberration compared to the monofocal IOLs. Contrast sensitivity revealed better values with MA30 and SA60 IOLs when compared to ReSTOR. The integration of wavefront technology in evaluating pseudophakic patients represents a step towards better understanding and analyzing postoperative visual quality.