Clinical Comparsion

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Clinical Comparsion After Implantation of Three
Different Aspheric IOLs
Neither author has a financial or proprietary
interest in any material or method mentioned.
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Introduction

• Advances in IOL technology using wavefront
  analysis induce the modifications of IOL surface
  to improve visual outcomes.
• Aspheric IOLs has been reported to compensate the
  spherical aberration(SA) of the cornea and
  improve contrast sensitivity, which provides
  patients with better quality of vision compared
  with conventional IOLs.
• The Tecnis 9003 IOL was designed to reduce to
  0.27 ? to correct corneal aberrations completely.
• The Acrysof IQ SN60WF IOL was designed to
  produce negative SA of 0.20 ?.
• The Adapt-AO IOL was designed to be aberration
  free to maintain only the positive SA of cornea
  to be unchanged.

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To compare the clinical results of implantation
of 3 different types of aspheric IOLs Tecnis
Z9000, Acrysof IQ, ADAPT-AO
Tecnis Z9003 Acrysof IQ Adapt AO
Structure pieces Single piece Single piece with 4 square edge
Material Hydrophobic acrylic Hydrophobic acrylic Hydrophilic acrylic
Aspherical feature Biconvex modified prolate ant. Surface -0.27 Posterior aspherical surface -0.17 Asymmetrical biconvex design with aspherical ant. post. Surface zero
A-constant 119.1 118.7 118.0
Characteristic feature Sharp image to retina Optimize vision quality Filtering of UV blue light Uniform power across its entire surface

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Materials and Methods
Prospective and randomized study 90 eyes of 90
patients
All cases were uncomplicated.
Group A 30 eyes implanted with Tecnis Z9003
(AMO, USA) Group B 30 eyes implanted with
AcrySof IQ SN60WF (Alcon, USA) Group C 30 eyes
implanted with Adapt-AO (Bausch Lomb, USA)
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Materials and Methods
6 Parameters to Evaluate the clinical Outcome of
3 IOLs Postoperative 2 and 6 months
Statistical analysis was done by Kruskall-Wallis
test
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Materials and Methods
Preoperative characteristics
Tecnis Z9003 (N30 eyes) Acrysof IQ (N30 eyes) Adapt AO (N30 eyes) p-value
IOL Power (Diopter) 20.621.51 20.252.06 20.341.47 0.526
UCVA 0.420.17 0.400.18 0.380.18 0.187
BCVA 0.510.17 0.490.17 0.420.22 0.174
Age 64.967.37 65.136.98 65.227.37 0.927
Sex (MF) 1218 1416 1218 0.825
UCVA uncorrected visual acuity BCVA best
corrected visual acuity
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Results visual acuity
Tecnis Z9003 Acrysof IQ Adapt AO P-value
UCVA POD 2mo 0.830.18 0.830.18 0.840.19 0.927
UCVA POD 6mo 0.810.20 0.870.10 0.800.23 0.142
BCVA POD 2mo 0.950.01 0.960.02 0.950.05 0.635
BCVA POD 6mo 0.950.03 0.930.06 0.940.02 0.156
VA change POD 2mo 0.380.09 0.350.39 0.380.46 0.906
VA change POD 6mo 0.350.13 0.300.41 0.370.33 0.291
VA change Postoperative BCVA Preoperative
BCVA
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Results - refractive error
Tecnis Z9003 Acrysof IQ Adapt AO P-value
Spherical equivalent (D) POD 2mo -0.39 0.53 -0.23 0.56 -0.18 0.52 0.12
Spherical equivalent (D) POD 6mo -0.13 0.37 -0.014 0.43 0.08 0.27 0.18
Refractive error (D) POD 2mo -0.17 0.55 0.21 0.56 0.31 0.41 0.063
Refractive error (D) POD 6mo -0.02 0.38 0.32 0.43 0.37 0.35 0.052
Refractive error (RE) postoperative spherical
equivalent target refraction SE Spherical
equivalent
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Results higher order aberrations
Tecnis Z9003 Acrysof IQ Adapt AO P-value
Coma (?) POD 2mo 0.038 0.093 0.031 0.072 0.038 0.11 0.957
Coma (?) POD 6mo 0.011 0.086 0.0530.084 0.062 0.064 0.786
Trefoil (?) POD 2mo 0.037 0.076 0.0043 0.075 0.026 0.048 0.476
Trefoil (?) POD 6mo 0.022 0.170 0.024 0.099 0.098 0.089 0.340
Spherical aberration (?) POD 2mo 0.0068 0.049 0.032 0.042 0.067 0.051 0.064
Spherical aberration (?) POD 6mo 0.0021 0.096 0.048 0.071 0.11 0.089 0.012
High order aberration (?) POD 2mo 0.16 0.066 0.17 0.059 0.19 0.074 0.319
High order aberration (?) POD 6mo 0.29 0.17 0.30 0.93 0.30 0.08 0.417
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Results Contrast Sensitivity Glare
cpd
Under low and high photopic conditions, there was
a statistically significant improvement in Tecnis
Z9003 group at POD 6 months.
Tecnis Z9003 Acrysof IQ Adapt AO P-value
Subjective glare sensation in POD 6mon Subjective glare sensation in POD 6mon 7 (2/30) 26 (8/30) 10 (3/30) 0.368
Sensitivity to glare POD 2mon 6.17 2.86 5.13 3.22 6.39 2.90 0.422
Sensitivity to glare POD 6mon 6.12 1.73 6.001.24 6.25 1.23 0.843
Sensitivity to glare decreased VA at photopic
condition measured by ACV
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Discussion

• Negative SA of IOL affected the postoperative
  spherical aberrations. Postoperative spherical
  aberration was lowest in the eyes implanted with
  Tecnis Z9003 IOL.
• 2. But, there were no significant differences in
  postoperative
• BCVA, refractive error, glare among 3
  different aspheric IOL groups.
• There was a statistically significant
  improvement in Tecnis Z9003
• group at POD 6 months, under low and high
  photopic conditions.
• 3. Three IOLs were different in IOL design and
  material of optic and haptic.
• In addition to the spherical aberrations,
  these are factors to affect the
• visual quality in each group.
• 4. We cannot confirm that what level of SA can
  maximize the quality of
• vision from this study.
• 5. Further studies are needed to analyze the
  effect of preoperative value
• of corneal SA to the quality of vision after
  implantation of different
• aspheric IOLs.

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Thank You for Your Attention !
ckjoo_at_catholic.ac.krhttp//cmc.cuk.ac.kr/lovis