Analysis of Wavefront Data Obtained With a Pyramidal Sensor in Pseudophakic Eyes Implanted With Diffractive Intraocular Lenses

Abstract

Purpose: To investigate the clinical validity of using wavefront measurements obtained with a recently available pyramidal aberrometer to assess the optical quality of eyes implanted with diffractive intraocular lenses (IOLs). Methods: Individual biometric data were used to create models of pseudophakic eyes implanted with two diffractive IOLs. Their synthetic wavefronts were calculated by ray-tracing with near infrared wavelength (0.85 μm). Comparisons of the through-focus visual acuity of 12 pseudophakic eyes were obtained with three different methods: clinical defocus curves; simulated defocus curves calculated from ray-tracing in the customized model eyes; and through-focus simulated defocus curves calculated from the wavefront data measured with a pyramidal aberrometer. Results: Image quality calculated from wavefront data obtained by ray-tracing with 0.85 μm wavelength, without scaling the phase to 0.55 μm, resulted in a significantly different through-focus curve compared to the reference values. Even so, after scaling of the wavefront data to 0.55 μm, the defocus curves calculated from the wavefronts measured with the pyramidal aberrometer did not match the shape and the depth of field of the clinical defocus curves or the theoretical expected values. Conclusions: Correcting for the longitudinal chromatic aberration of the eye when measuring the wavefront of eyes implanted with diffractive IOLs under near infrared light only accounts for the best focus shift due to the longitudinal chromatic aberration, but not for the wavelength dependence of the diffractive element. The pyramidal sensor does not seem to properly sample the slopes of a wavefront measured from a pseudophakic eye implanted with a presbyopia-correcting diffractive IOL to a clinically acceptable level. [ J Refract Surg . 2023;39(7):438–444.]