To analyze the feasibility of selectively targeting about+0.1μm total post-operative spherical aberration by selecting the best fit aspheric intraocular lens (IOL) based on iTrace measured preoperative corneal spherical aberration of patients, and then evaluate visual quality of the patients with personalized aspheric IOL implantation using a variety of visual quality evaluation index objectively.

A total of 115 cataract patients (115 eyes) were divided into experimental group (63 eyes) and control group (52 eyes) randomly. The cornea spherical aberration at 6 mm pupil diameter was measure with an iTrace Visual Function Analyzer 1 day before surgery. The target postoperative total spherical aberration was at about+0.1μm in the experimental group, thus, for corneal spherical aberration less than+0.15μm, the Rayner 920H IOL of zero spherical aberration was selected, for corneal spherical aberration at+0.15μm~+0.35μm, the Acrysof SN60WF IOL of -0.20um spherical aberration was selected, for corneal spherical aberration greater than +0.35um, the Tecnis ZCB00 IOL of -0.27um was selected. While, Rayner 920H IOL was implanted into the control group. The value of high-order aberrations (HOAs), modulation transfer function (MTF) and sterol Ratio (SR) at 3 mm and 6 mm aperture were measure with iTrace 3 months after surgery, the Visual Optics Lab-CT software was used to calculate the depth of focus (DOF). t-test and ANO-VA were used to analyze the data, and P <0.05 was significantly different.

There was no significantly difference between the predicted value and actual value of the postoperative spherical aberration as while as the absolute error for all the patients (P >0.05). Postoperative visual quality analysis: When at 3mm pupil diameter, total ocular spherical aberration C₄₀, coma, trefoil, total high-order aberration RMS value, MTFtHOA, SR and DOF had no significantly difference between the two groups (P >0.05). When at 6mm pupil diameter, total ocular coma, trefoil and DOF had no significantly difference between the two groups (P >0.05), while total ocular spherical aberration C₄₀, total high-order aberration, MTFtHOA and SR had significantly difference between the two groups (P <0.05).

Customized selection of aspheric IOL based on iTrace measured preoperative corneal spherical aberration targeting about +0.1μm total postoperative spherical aberration is feasible, and the objective visual quality of the patients with personalized aspheric IOL implantation is better at large pupil diameter.

Personalized implantation; Aspheric IOL; Sterol Ratio; Depth of focus; MTF; HOAs