Residual refractive error and visual outcome after cataract surgery using spherical versus aspheric IOLs

■ BACKGROUND AND OBJECTIVE: To evaluate the effect of the residual refractive error on uncorrected distance visual acuity (UCVA) after cataract surgery using spherical versus aspheric intraocular lenses (IOL). ■ PATIENTS AND METHODS: There were 160 eyes of 125 patients who underwent uneventful cataract surgery included. Of these, 80 eyes received spherical IOLs and 80 eyes aspheric IOLs. Corneal astigmatism was measured preoperatively. Visual acuity, manifest refraction, scotopic pupil size, and spherical aberration were measured postoperatively and analyzed to determine the independent effects of postoperative astigmatism, sphere, spherical equivalent (SE), absolute value of SE, scotopic pupil size, and spherical aberration on postoperative UCVA. Eyes with postoperative astigmatism greater than 2.0 diopters were excluded. ■ RESULTS: Postoperative UCVA showed significant correlation with age, postoperative residual astigmatism, and absolute value of SE in eyes with spherical IOLs. However, postoperative UCVA showed significant correlation with only the absolute value of SE in the aspheric IOL group. ■ CONCLUSION: Eyes with spherical IOLs had good UCVA as long as the residual astigmatism was small. However, eyes with aspheric IOLs performed better in UCVA when the residual astigmatism was 1.5 diopters or greater.