Using adaptive optics to optimize the spherical aberration of eyes implanted with extended depth of focus and enhanced monofocal IOL

Abstract

Purpose: To assess impact of change in ocular spherical aberration (SA) with adaptive optics on visual acuity at different defocus post implantation of extended depth of focus (EDOF) and enhanced monofocal intraocular lenses (IOL) Settings: Narayana Nethralaya eye hospital, India Design: Prospective, longitudinal, observational Methods: Eighty eyes (40 patients), which had cataract surgery, were included in the study. Forty eyes were implanted with Eyhance EDOF IOL (Johnson and Johnson, USA) and the remaining with Vivity EDOF IOL (Alcon Laboratories Inc. USA). Baseline ocular aberrations were measured with Visual adaptive optics aberrometer (VOPTICA, Spain). Then, the optimal SA was determined by increasing it in steps of -0.01 µm up to -0.1 µm till the maximum improvement in near distance VA was observed for a given eye. Then, defocus curve for each eye was measured after modifying the ocular SA by magnitude equal to optimal SA. Results: Most eyes accepted a negative induced SA of -0.05 µm (Eyhance group: 67.6%; Vivity group, 45.2%). In the Eyhance group (dominant eyes), VA improved at -2 D (p<0.02) only, and degraded at 0 D, +0.5 D and +1 D defocus (p<0.05). In the Vivity group, the VA remained unchanged at all defocus (p>0.05). In the Eyhance group (non-dominant eyes), VA improved at -3.5 D defocus only, and degraded at +1.5 D and +2 D defocus (p<0.05). In the Vivity group, a VA improved at -2.5 D defocus (p<0.05) only. Conclusions: A negative induced SA of -0.05 µm in implanted eyes was optimal for a slight improvement in distance corrected near and intermediate VA without any significant decrease in baseline distance corrected VA.