Combine neutral aspheric IOL and small incision for aberration-free cataract surgery

BARCELONA — Small 1.8-mm incision cataract surgery with implantation of a neutral aspheric IOL leads to an aberration-free outcome, according to a study on 40 consecutive eyes presented here.

"Forty patients undergoing cataract surgery [with] less than 1 D of astigmatism were randomly assigned to either 1.8-mm or 3.2-mm incision coaxial phacoemulsification," Simonetta Morselli, MD, said at the meeting of the European Society of Cataract and Refractive Surgeons. "To minimize the effect of the intraocular lens on the total eye aberration, the Akreos MI60 IOL (Bausch & Lomb) was implanted in all study eyes. Postoperatively, the corneal and total aberrations of the two groups were compared using the Topcon KR-9000PW topographer/aberrometer."

The eyes with the smaller incision showed no change in corneal aberration, while in the eyes with a 3.2-mm incision, coma increased from 0.35 ± 0.11 µm to 0.42 ± 0.12 µm and fourth-order astigmatism increased from 0.08 ± 0.02 µm to 0.12 ± 0.03 µm.

"The implantation of a neutral aspheric IOL makes a lot of sense in small-incision surgery because neither the incision nor the lens induce aberrations, and the aberration outcome can be predicted from simple observation of the preoperative corneal topography," Dr. Morselli said.

This combination produces "aberration-free" cataract surgery and favors the choice of neutral aspheric IOLs for everyday cataract surgery, she said.