Comparison of Ocular Wavefront Aberrations in Subluxated Lenses Before and After Lens Extraction With IOL Implantation

Saturday, April 18, 2015: 3:16 PM
Room 5A (San Diego Convention Center)
Samaresh Srivastava, DNB
Vaishali Vasavada, MS
Shail A. Vasavada, DO, DNB, FICO
Viraj A. Vasavada, MS
Abhay R. Vasavada, MS, FRCS

To document the ocular wavefront aberrations, visual acuity and modulation transfer function in patients with subluxated lenses of any etiology preoperatively and then evaluate changes following subluxated lens surgery with IOL implantation.

Prospective, interventional, observational case series. 30 eyes of 30 patients with subluxated lenses undergoing lens extraction with IOL implantation were included. Depending on extent of subluxation, either an in the bag IOL along with Cionni ring fixation or a scleral fixation of IOL was performed. Ray tracing aberrometry (iTrace) was performed in all eyes preoperatively and 4-6 weeks postoperatively under mesopic conditions without pupillary dilatation. Total root mean square (RMS) value for higher order aberrations (HOAs), coma and spherical aberration(SA) were compared pre and postoperatively. Best corrected visual acuity and Modulation transfer function (MTF) were also compared pre and 4-6 weeks postoperatively.

Ongoing study, results will be updated. In 20 eyes, preoperative mean RMS value (mean+SD) for total HOAs, coma and SA were: 10.53+7.6, 2.99+2.3 and 0.37+0.85 microns respectively. Postoperatively, there was a statistically significant reduction in RMS value for total HOAs (P<0.05). Mean (+SD) values for HOAs, coma and SA  were: 0.74+0.38, 0.12+0.09 and 0.027+0.06 microns respectively. RMS for HOAs improved in all eyes, although Snellen’s BCVA did not improve in 4 of the 20 eyes (20%). Modulation transfer function also improved significantly in all eyes from preoperatively to postoperatively.

Lens extraction with IOL implantation significantly improves patients’ ocular aberration profile and modulation transfer function. Even with a minor degree of subluxation, significant HOAs can be induced. Therefore, even where BCVA is not likely improve, surgery  maybe indicated to improve the patients’ quality of vision.