Comparison of contrast sensitivity between three aspheric acrylic monofocal intraocular lenses: a prospective randomised trial

Abstract

Introduction: Evolution of cataract surgery and implantation of intraocular lenses (IOL) with new technological designs to optimise functional vision has been the aim of cataract surgery today. Aspherical lens design is a new lens technology to counteract spherical aberration exerted by a conventional IOL.

Purpose: To compare the contrast sensitivity after cataract surgery between aspheric IOLs with negative spherical aberration (Tecnis ZA9003TM and AcrySof IQTM) and zero spherical aberration IOLs (Akreos Adapt Advance Optic [AO]TM).

Study design: Interventional, single-blinded, randomised controlled trial.

Methods: Ninety-six patients were recruited with 32 eyes in each study arm. All patients underwent standard phacoemulsification with implantation of an aspheric acrylic IOL randomised to one of the three lens models by a single experienced surgeon. Pre- and postoperative contrast sensitivity was analysed using the CSV1000E chart under photopic and mesopic conditions with and without glare testing.

Results: All three lenses showed statistically significant improvement in contrast sensitivity postoperatively at all spatial frequencies under photopic, mesopic, and scotopic conditions with glare. There was no statistically significant difference between the groups. Tecnis ZA9003TM showed marked improvement in mesopic contrast sensitivity at 18 cycles/degree (cpd) at 12 weeks (p < 0.05). The zero aberration Akreos Adapt AOTM showed better photopic contrast sensitivity compared to mesopic contrast sensitivity (p > 0.05).

Conclusion: AcrySof IQTM, Akreos Adapt AOTM, and Tecnis ZA9003TM performed equally well in contrast sensitivity at all spatial frequencies under photopic and mesopic conditions with and without glare testing. All lenses had statistically significant improvement in contrast sensitivity after cataract surgery. The negative aberration IOL Tecnis ZA9003TM showed marked improvement in mesopic contrast sensitivity at 18 cpd at 12 weeks. The zero aberration IOL, Akreos Adapt AOTM showed better photopic contrast sensitivity compared to mesopic contrast sensitivity.