Effect of tilt of 2 acrylic intraocular lenses on high-order aberrations.

Purpose: To investigate the high-order aberrations (HoAs) in pseudophakia between 2 foldable acrylic intraocular lenses (IOL) with differences in the tilt of IOL.
Setting: Department of Ophthalmology, Nara Medical University, Nara, Japan.
Method: Sixty-four eyes that had uncomplicated phacoemulsification and IOL implantation were assigned to 1 of 2 groups: Acryfold 60BB (HOYA [n=30 eyes]) and AcrySof MA60AC (Alcon [n=34 eyes]). All patients had best corrected visual acuity better than 20/25. High-order aberrations were measured using the Hartmann-Shack aberrometer at 4.0 mm and 6.0 mm wavefront aperture diameters, and the IOL tilt and decentration were measured using Scheimpflug videophotography.
Results: There was a significant difference in the IOL tilt (60BB=2.22 degrees +/- 1.44 (SD), 60AC=3.18 +/- 1.84 degrees; P=.041, Mann-Whitney U test), but no difference in IOL decentration (P>.05). In the cornea, there were no differences between the 2 groups in HoAs at 4.0 mm and 6.0 mm aperture diameters (P>.05, Mann-Whitney U test). In the whole eye, there was no difference between the 2 groups in spherical-like aberrations, coma-like aberrations, and total aberrations at the 4.0 mm and 6.0 mm aperture diameters (P>.05). The compensation of the internal optics with the 60BB group was better than with the 60AC group for coma-like (P=.037) and total aberrations (P=.010) at 6.0 mm aperture diameter.
Conclusion: The smaller tilt of the IOL induced more compensation for the coma-like and total aberrations at the 6.0 mm aperture diameter. The IOL tilt should be small, especially in a large pupil, with regard to HoAs.