Predicting the optical performance of eyes implanted with IOLs to correct spherical aberration

PURPOSE. To use powerful modeling techniques for predicting the optical performance of eyes implanted with different types of intraocular lenses (IOLs). This approach will allow performance of "virtual cataract surgery," with different IOL designs that can be used and physical parameters that may occur during actual surgery-in particular, in IOLs that correct spherical aberration. METHODS. A computer model was developed to predict the optical performance of individual eyes after IOL implantation. The approach was validated in a group of patients with eyes implanted with different IOLs. In these patients, corneal wave-front aberrations were calculated from elevations provided by videokeratography. Ocular aberrations were measured with a high-dynamic range Hartmann-Shack wavefront sensor. Misalignments (IOL tilt and decentration) were estimated with a new instrument, based on recording Purkinje images. This model of particular corneal aberrations and IOL parameters (intrinsic optical design details plus geometric location data) was used to estimate the total ocular aberrations after surgery and to compared them with actual aberrations measured directly with the wavefront sensor. RESULTS. The aberrations of implanted eyes predicted by the individualized optical models were well correlated with the actual aberration measured in each subject. This result indicates that the approach is adequate in evaluating the actual optical performance of different types of lenses. The model allows a large number of "virtual" surgeries to be performed, to test the performance of current or future IOL designs. CONCLUSIONS. A "virtual surgery" approach was designed to predict the optical performance in pseudophakic eyes. In each subject, it was possible to obtain the eye's optical performance with a particular IOL and biometric data after surgery. Specifically, this modeling can be used to evaluate the tolerances to misalignments and depth of focus of IOLs correcting spherical aberration in actual eyes. This approach is quite powerful and is especially applicable to the study of current and future aberration-correction IOL designs.