Optical behavior of the eye implanted with extreme intraocular lens powers

Purpose: To evaluate the induced ocular aberrations after cataract surgery with extreme low- powered and high-powered spherical monofocal intraocular lenses (IOLs) using a new pyramidal wavefront sensor aberrometer. Setting: Vissum Institute Oftalmologico, Alicante, Spain. Design: Prospective observational comparative study. Methods: This study included patients who had cataract surgery with implantation of a spherical monofocal IOL The patients were divided into three groups according to the IOL power. Group 1: +20 diopters (D) to +23 D; Group 2: less than +10 D; and Group 3: +29 D or more. Assessment after 3 months included: uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, contrast sensitivity function test (Ginsburg), corneal aberrometry, and total ocular aberrometry with a pyramidal wavefront sensor aberrometer (Osiris) for 4.0 mm, 4.5 mm, and 5.0 mm pupil diameters. Results: The study comprised 88 eyes of 56 patients. There were no differences between all groups in terms of refractive error, corneal aberrometry, or total ocular higher-order aberrations at any analyzed pupil diameter. The ocular spherical aberration (SA) was not significantly different between groups with a 4.0 mm pupil. The SA was significantly lower in Group 2 when compared with Group 1 and Group 3 for both 4.5 mm (P =.01 and P =.001, respectively) and 5.0 mm (P =.002 and P =.002, respectively). There was no significant difference in SA between Group 1 (+20 D to 23 D) and Group 3 (>= +29 D) at any analyzed pupil diameter. Higher SA did not correlate to lower contrast sensitivity. Conclusions: Despite the theoretical evidence, only a negligible amount of clinically insignificant aberrations were induced by high-powered positive IOLs. Low-powered IOLs did not induce significant levels of SAs. (C) 2019 ASCRS and ESCRS