Saarland University, Institute of Experimental Ophthalmology, Kirrberger Str. 100, Bldg. 22, D-66424, Homburg/Saar, Germany.
University of Rochester, Institute of Optics, 275 Hutchison Road, Rochester, NY, 1427-0186, USA.
Sci Rep. 2019 Mar 5;9(1):3479. doi: 10.1038/s41598-019-39904-w.
We investigated whether eyes with keratoconic corneal tomography pattern could benefit more from aberration correction with custom intraocular lenses (IOLs) than normal cataractous eyes despite the effect of misalignment on the correction of aberrations. Custom IOLs (cIOLs) were calculated for twelve normal and twelve keratoconic eyes using personalized numerical ray tracing models. The Stiles-Crawford weighted root-mean-square spot-size (wRMS) at the virtual fovea was evaluated for cIOLs and aberration-neutral IOLs (nIOLs) in a simulated clinical study with 500 virtual IOL implantations per eye and per IOL. IOL misalignment (decentration, tilt, rotation) and pupillary ectopia (4.5 mm iris aperture) were varied upon each virtual implantation. The nIOLs achieved average wRMS of 16.4 ± 4.3 μm for normal, and 92.7 ± 34.4 μm for keratoconic eyes (mean ± standard deviation). The cIOLs reduced the average wRMS to 10.3 ± 5.8 μm for normal, and 28.5 ± 18.6 μm for keratoconic eyes. The cIOLs produced smaller wRMS than nIOLs in most virtual implantations (86.7% for normal and 99.4% for keratoconic eyes). IOL misalignment resulted in larger wRMS variations in the keratoconus group than in the normal group. Custom freeform IOL-optics-design may become a promising option for the correction of advanced aberrations in eyes with non-progressive keratoconic corneal tomography pattern.
我们研究了在存在像差情况下，角膜像差模式异常的圆锥角膜眼是否比正常白内障眼能从定制人工晶状体（IOL）的像差矫正中获得更多的益处。使用个性化数值光线追踪模型为 12 只正常眼和 12 只圆锥角膜眼计算了定制 IOL（cIOL）。在每只眼和每只 IOL 500 个虚拟 IOL 植入的模拟临床研究中，评估了虚拟黄斑处的斯特尔克斯-克劳福德加权均方根光斑大小（wRMS），比较了 cIOL 和无像差人工晶状体（nIOL）。在每次虚拟植入时，改变了 IOL 离焦（偏心、倾斜、旋转）和瞳孔异位（4.5mm 虹膜孔径）。nIOL 为正常眼获得平均 wRMS 为 16.4±4.3μm，为圆锥角膜眼获得 92.7±34.4μm（平均值±标准差）。cIOL 将正常眼的平均 wRMS 降低至 10.3±5.8μm，将圆锥角膜眼的平均 wRMS 降低至 28.5±18.6μm。在大多数虚拟植入中，cIOL 产生的 wRMS 小于 nIOL（正常眼为 86.7%，圆锥角膜眼为 99.4%）。在圆锥角膜组中，IOL 像差导致的 wRMS 变化大于正常组。自由曲面定制 IOL 光学设计可能成为矫正进展性圆锥角膜角膜像差模式眼的高级像差的一种有前途的选择。
