Extended Depth of Focus With Induced Spherical Aberration in Light-Adjustable Intraocular Lenses

American Journal of Ophthalmology
Eloy A. Villegas, Encarna Alcon, Sandra Mirabet, Inés Yago, José M. Marín, Pablo Artal

Purpose: To evaluate the quality of vision and depth of focus induced by controlled amounts of negative spherical aberration in patients implanted bilaterally with lightadjustable intraocular lenses.
Design: Prospective nonrandomized clinical trial.
Methods: Seventeen patients were implanted and treated with appropriate spatial irradiance light profiles. One eye was set for emmetropia, and the fellow eye received an additional aspheric light treatment to induce controlled amounts of negative spherical aberration. We used a Hartmann-Shack sensor to measure the eye’s refraction and aberrations for a 4-mm pupil diameter. Decimal visual acuity (VA) was measured using a micro-display placed at 10 m, 60 cm, 40 cm, and 30 cm.
Results: Eyes treated with aspheric profiles were divided into 2 groups depending on the final amount of induced negative spherical aberration: low [L0.05, L0.10 mm] and high [L0.13, L0.23 mm]. In both groups, the mean uncorrected decimal VA at 60 cm was over 0.90. In the first group, distance VA was 0.97 ± 0.16, but in the second group it was lower (0.76 ± 0.16). As expected, the VA for nearer distances is higher in the eyes with a larger magnitude of spherical aberration (P value < .01): 0.94 ± 0.10 and 0.73 ± 0.16 at 40 and 30 cm, respectively, in comparison with 0.71 ± 0.15 and 0.50 ± 0.14. Binocular summation with the fellow eye, adjusted for emmetropia, produces an excellent binocular distance VA (>1.10) in both groups.
Conclusions: Controlled amounts of negative spherical aberration and defocus can be induced in eyes implanted with adjustable intraocular lenses to enhance near vision.