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Refractive Aspect of Cataracts – Towards Customisation
Figure 1: The Micro AY Intraocular Lens (PhysIOL) Figure 3: Micro AY at the End of Surgery
Figure 2: Best Corrected Visual Acuity Figure 4: Contrast Vision (ETDRS)
0.97 0.35
1.0
0.30
0.9
0.25
0.8
0.20
0.14
0.7
0.15
0.6 0.10
0.11
0.5
0.48
0.05
0.17
logMAR visual acuity
0.10
0.07
0.4
0.00
-0.05 -0.08
Decimal visual acuity
0.3
-0.10
100% contrast
0.2
25% contrast 9% contrast
e-type AV
0.1
0.0
AV = arteriovenous; EDTRS = Early Treatment Diabetic Retinopathy Study.
Best corrected visual acuity
Pre-operative (n=124) 3 months (n=101)
Figure 5: Comparison of Defocus Curves
of spherical lenses, confirming that there was a slight decrease of DF
1.2
(see
1.00
Figure 5) but to a lesser extent than in full correcting SA IOLs.
1.0
This study confirmed that the refractive approach to SAs of the cataract
0.78
0.8
0.76
improved the pseudophakic’s quality of vision. On the whole,
0.66
customising the correction of SAs will depend on the corneal
0.6
topography in certain cases: young adults driving at night, patients with
0.46
0.4
large pupils, those with diffractive multifocal IOLs and patients with
Decimal visual acuity
0.34
0.38
particular corneal profiles, especially those having undergone refractive
0.2
surgery. Indeed, it has been pointed out that a mean partial correction
of SAs in all of the studies shows an increase in contrast sensitivity with
0.0
+1.50 +1.00 +0.50 0 -0.50 -1.00 -1.50
implants having an aspherical optic as long as the implant is correctly Diopters
centred. However, correcting spherical aberrations will always come Micro AY VA Spherical IOL VA
after the correction of spherical and cylindrical ametropia relevant to
the quality of surgery and the precision of biometrical calculations.
IOl = intraocular lens; VA = visual acuity.
n
1. Levy Y, Segal O, Avni I, Zadok D, Ocular higher-order 2. Nochez Y, Favard A, Majzoub S, Pisella PJ, Measurement of cataract surgery, Br J Ophthalmol, 2009;(Epub ahead of
aberrations in eyes with supernormal vision, Am J corneal aberrations for customization of intraocular lens print).
Ophthalmol, 2005;139(2):225–8. asphericity: impact on quality of vision after micro-incision
EUROPEAN OPHTHALMIC REVIEW 81
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