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Young eyes for elderly people : a clinical comparison of spherical and aspheric intraocular lenses

(2009) Gaalen, Kim Warda van

Cataract, a common cause of decreased vision, is caused by chemical changes in the crystalline lens, leading to a loss of transparency which is associated with a loss of visual acuity and contrast sensitivity and increased disability glare. The cataractous lens can be replaced surgically with an artificial intraocular lens (IOL), restoring optical performance. Initially, IOL designs were spherical, increasing the spherical aberration; one of the most important aberrations of the human eye optics. In the crystalline lens the spherical aberration increases with age. Therefore, to optimize the optical performance of eyes to the level of young eyes, the aspheric IOL was designed. In this thesis, we compared the optical performance of eyes with spherical and aspheric IOLs.
Implantation of the aspheric IOL succesfully lowered the spherical aberration of the eye optics to the level of young healthy eyes. Optical performance, however, did not differ significantly from eyes implanted with a spherical IOL. A possible explanation is that, besides spherical aberration, other aberrations could influence the optical performance. Furthermore, aberrations may have a major advantage; eyes with a spherical IOL tended to have a larger depth of focus. To decide in clinical practice which type of IOL should be preferred for a patient, future research has to reveal the essential characteristics of the eye.

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