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Variations in refractive analysis with different diffractive multifocal intraocular lenses using different wavefront ana

Variations in refractive analysis with different diffractive multifocal intraocular lenses using different wavefront analyzers. Mami Yoshino, Hiroko Bissen-Miyajima, Shinichi Oki, Keiichiro Minami, Kunihiko Nakamura Department of Ophthalmology

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Variations in refractive analysis with different diffractive multifocal intraocular lenses using different wavefront ana

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  1. Variations in refractive analysis with different diffractive multifocal intraocular lenses using different wavefront analyzers MamiYoshino, Hiroko Bissen-Miyajima, Shinichi Oki, Keiichiro Minami, Kunihiko Nakamura Department of Ophthalmology Tokyo Dental College Suidobashi Hospital, Tokyo, Japan Naoyuki Maeda Department of Ophthalmology Osaka University Medical School, Osaka, Japan Yoshino, Bissen-Miyajima, Oki, Minami and Nakamura: No financial Interest Maeda: Research grant recipient from Topcon Corp.

  2. PURPOSE It is still under discussion whether the Hartman-Shack wavefront analyzer represents real wavefront aberration of the multifocal intraocular lens (MF-IOL) implanted eye. This study evaluated the refractions of diffractive MF-IOL implanted eyes using two wavefront analyzers with manifest refraction.

  3. SUBJECTS 15 eyes of 8 patients who received diffractive MF-IOL

  4. METHODS To verify if the wavefront analyzer results represent real wavefront aberration, refraction data were compared with those with manifest Manifest Refraction VS: 0.9 (1.2 x +0.75D sph. cyl. -0.75 D) Spherical refraction Refraction by wavefront analyzer Cylindrical refraction • KR-9000PW (Topcon, Japan) • WaveScan (AMO, US)

  5. Hartmann-Shack spotimages and evaluation KR-9000PW WaveScan ZM900 SA60D3 ZM900 SA60D3 Spots were doubled Spots were clearer in the center Spots were doubled or not clear Analysis difficult due to spot irregularity Optical zone: 4 mm & 6 mm Optical zone:5.94±0.75 mm Evaluation was possible in all eyes tested 3 eyes failed for evaluation

  6. RESULTS：　 KR-9000PW

  7. RESULTS： WaveScan

  8. DISCUSSION： Reliability of refraction with Hartmann-Shack analyzer • The difference of spherical and cylindrical refractions between manifest and wavefront were within 0.5D. • Coincidence in refraction may support that Hartmann-Shack analyzer measures distance wavefront of diffractive MF-IOL properly.

  9. DISCUSSION： Differences between 2 wavefront analyzers • Cyrindrical refraction was very close between KR-9000PW and WaveScan. • With KR-9000PW, spherical refraction was closer to manifest. Differences between 2 multifocal IOLs • Hartmann-Shack images were clearer and easier to be analyzed in eyes with ZM900.

  10. CONCLUSION • In this preliminary study, the difference between the wavefront refraction and manifest refraction can be influenced by the design of the diffractive MF-IOL and the characteristics of the wavefront analyzer. • These effects should be considered for not only 2nd order aberration, but also higher order aberration in eyes with diffractive MF-IOLs.

  11. REFERENCES • Rocha KM, Chalita MR, Souza CE,el al. Postoperative wavefront analysis and contrast sensitivity of a multifocal apodized diffractive IOL (ReSTOR) and three monofocal IOLs. J Refract Surg. 2005;21:S808-12. • Zelichowska B, Rekas M, Stankiewicz A, et al. Apodized diffractive versus refractive multifocal intraocular lenses: optical and visual evaluation. J Cataract Refract Surg. 2008;34:2036-42. • Campbell CE. Wavefront measurements of diffractive and refractive multifocal intraocular lenses in an artificial eye. J Refract Surg. 2008;24:308-11. • Charman WN, Montés-Micó R, Radhakrishnan H. Problems in the measurement of wavefront aberration for eyes implanted with diffractive bifocal and multifocal intraocular lenses. J Refract Surg. 2008;24:280-6. • Jendritza BB, Knorz MC, Morton S. Wavefront-guided excimer laser vision correction after multifocal IOL implantation. J Refract Surg. 2008;24:274-9

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