Feasibility of spherical aberration correction with aspheric intraocular lenses in cataract surgery based on individual pupil diameter

Purpose: To evaluate the feasibility of correcting spherical aberration with aspheric intraocular lenses (IOLs) in cataract surgery based on individual pupil diameter. Setting: Keio University Hospital, Tokyo, Japan. Methods: In this prospective study, eyes having cataract surgery were divided into 4 groups based on IOL type: aspheric SN (AcrySof SN60WF), aspheric ZA (Tecnis ZA9003), aspheric PY (Hoya PY-60 AD), and spherical (AcrySof Natural SN60AT). Postoperative higher-order aberrations (HOAs) of the cornea and whole eye and the pupil diameter under photopic and mesopic conditions were measured. The HOA was calculated using the individual pupil diameter. The correlation between corneal and ocular spherical aberrations and pupil diameter was evaluated. Results: Each group comprised 30 eyes. Ocular spherical aberrations were significantly lower than corneal spherical aberrations under mesopic conditions in the aspheric SN group, the aspheric ZA group, and the aspheric PY group (P<.05); there was no significant difference between the aberrations in the spherical group. Linear regression showed significant correlations between postoperative corneal and ocular spherical aberrations (β = 0.39, aspheric SN; β = 0.38, aspheric ZA; β = 0.58, aspheric PY; β = 0.79, spherical). The differences in corneal and ocular spherical aberrations were significantly correlated with pupil diameter in the aspheric IOL groups but not in the spherical IOL group. Conclusions: The amount of spherical aberration correction by aspheric IOLs varied depending on IOL type and individual pupil diameter. The linear regression equation in this study may make it possible to customize postoperative ocular spherical aberration after cataract surgery.