1. Spherical Aberration Post Bilateral Implantation of Two Prevalent Aspheric IOLs DR. ROBERT A. KAUFER, MD MARTINEZ, BUENOS AIRES ARGENTINA robert@kaufer.com This research funded by Alcon Laboratories.

2. To determine the aspheric lens with the best clinical outcomes in a real-world setting where preoperative wavefront analysis for aspheric lens customization is not the standard of care. Purpose

3. Final enrollment 37 bilateral patients 18 SN60WF 19 Z9000 Healthy eyes Postop exam 3 months after surgery Spherical Aberration (SA) Trace aberrometer/topographer (Tracey Technologies) Non-dilated 4.5mm scan VA Contrast Methods

4. SN60WFZ9000 DesignSingle PieceMulti-Piece Optic Zone6.0 mm Central Optic Thickness 0.61 mm0.50 mm ChromophoreBlue Light FilterNone Aspheric Surface Posterior Anterior Lens SA-0.21 μm-0.27 μm Residual SA by Design 0.1 μm0.0 μm Residual SA by Design 0.1 μm0.0 μm IOL Specifications

5. 72% 68% Lens had no apparent effect on amount of postoperative SA n=74 eyes 0 5 10 15 20 25 30 SN60WFZ9000 Lens Model Percent <=0.025 0.025-0.050 0.05-0.075 0.075-0.1 0.1-0.125 0.125-0.150 0.15-0.175 0.175-0.2 >0.2 Percent Distribution of Postop Spherical Aberration (μm)

6. If lens model had no effect on postop SA distribution… Does lens model have an effect on performance at a specified SA range? Patients broken into 3 groups <0.1μm postop SA OU >0.1μm postop SA OU Mixed (one eye 0.1 μm) Results Analysis

7. <0.1μm>0.1μmMixed 20/20 20/16 Snellen -0.10 -0.08 -0.06 -0.04 -0.02 0.00 LogMAR (n=22)(n=9)(n=6) Binocular BCVA with Three Postop SA Groups

8. 20/20 Snellen 20/25 20/30 20/40 20/50 20/63 20/80 0.00 0.10 0.20 0.30 0.40 0.50 0.60 PhotopicMesopic LogMAR <0.1 OUMixed>0.1 OU (n=22)(n=9)(n=6) 12.5% Low Contrast Acuity with Three Postop SA Groups

9. 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 2.20 1.5361218 Cycles/Degree Log Units <0.1 OU>0.1 OUMixed (n=22)(n=9)(n=6) Photopic Contrast Sensitivity with Three Postop SA Groups

10. 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 2.20 1.5361218 Cycles/Degree Log Units <0.1 OU>0.1 OUMixed Mesopic Contrast Sensitivity with Three Postop SA Groups

11. 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2.00 2.20 1.5361218 Cycles/Degree Log Units <0.1 OU>0.1 OUMixed Mesopic with Glare Contrast Sensitivity with Three Postop SA Groups

12. A slight positive postoperative SA (>0.1 μm) appears to enhance visual acuity. Larger populations are likely required to evaluate the modest impact of SA on contrast. Postoperative SA alone was not a predictor of contrast sensitivity. Postoperative analysis should include coma and total HOA to account for all residual aberrations of the eye. Conclusions