Analysis of the effect of intraocular lens tilt and decentration on induced astigmatism by ray tracing on the model eye

Purpose. Determination of the influence of the intraocular lens (IOL) inclination and decentration on the magnitude of induced astigmatism in a theoretical study using software on an eye model. Material and methods. An eye model with the specified parameters was performed to carry out the calculation. Modulation of the change in the wavefront was carried out using the Zemax program (LLC, USA). In the model eye, the probability of induction of astigmatism was analyzed depending on the change in the position of the aspherical IOL Acrysof IQ 16.0, 22.0 and 24.0 diopters and the toric model Acrysof IQ Toric SN6AT3, SN6AT4 and SN6AT5. The angle of inclination of the IOL relative to the horizontal plane was examined from 0° to 10° with a step of 1°, decentration from 0.1 to 1.5 mm with a step of 0.1 mm. At each IOL position, aberration data of the 2nd order Z (2, 2) were recorded. The obtained results were used to calculate the critical tilt angle and decentration. Results. The magnitude of induced astigmatism increased with the rise of the degree of inclination and decentration, corresponding to an increase in the optical power of the IOL. Accordingly, critically significant were the values of 3.0° inclination for the aspherical IOL with an optical power of 22.0 and 22.0 diopters and 3.5° for 16.0 diopters, decentration – 0.7 mm and 1.0 mm. The inclination of the TIOL relative to the horizontal plane revealed the induction of the magnitude of inverse astigmatism, according to an increase in the inclination angle of 0.3 diopters at a slope of 3–4°. Conclusions. The tilt and decentration of the aspherical and TIOL patterns induce astigmatism depending on the increase in IOL power. The inclination of the TIOL in relation to the horizontal plane set at 90 ° promotes the induction of astigmatism. Key words: astigmatism, toric intraocular lenses, tilt and decentration of the intraocular lens, ray tracing

Effect of Spherical Aberration on the Optical Quality after Implantation of Two Different Aspherical Intraocular Lenses

Purpose. To compare the effect of spherical aberration on optical quality in eyes with two different aspherical intraocular lenses. Methods. 120 eyes of 60 patients underwent phacoemulsification. In patients’ eyes, an aberration-free IOL (Aspira-aA; Human Optics) or an aberration-correcting aspherical IOL (Tecnis ZCB00; Abott Medical Optics) was randomly implanted. After surgery, contrast sensitivity and wavefront measurements as well as tilt and decentration measurements were performed. Results. Contrast sensitivity was significantly higher in eyes with Aspira lens under mesopic conditions with 12 cycles per degree (CPD) and under photopic conditions with 18 CPD (p=0.02). Wavefront measurements showed a higher total spherical aberration with a minimal pupil size of 4 mm in the Aspira group (0.05 ± 0.03) than in the Tecnis group (0.03 ± 0.02) (p=0.001). Strehl ratio was higher in eyes with Tecnis (0.28 ± 0.17) with a minimal pupil size larger than 5 mm than that with Aspira (0.16 ± 0.14) (p=0.04). In pupils with a minimum diameter of 4 mm spherical aberration had a significant effect on Strehl ratio, but not in pupils with a diameter less than 4 mm. Conclusions. Optical quality was better in eyes with the aberration-correcting Tecnis IOL when pupils were large. In contrast, this could not be shown in eyes with pupils under 4 mm or larger. This trial is registered with Clinicaltrials.gov NCT03224728.