Impact of Cataract Surgery on Higher Order Aberrations and Comparative Analysis using Scheimpflug imaging and ray-tracing technology.

Abstract

Objective: This study aims to evaluate higher-order aberrations (HOAs) pre- and post-cataract surgery using advanced technologies to achieve an acceptable best-corrected visual outcome in favor of patients.

Methods: This prospective, observational study involves 200 adult patients (aged 40 years or older) undergoing cataract surgery. All these patients have been evaluated before and after cataract surgery.The study involved comprehensive measurements of higher-order aberrations (HOAs) using both Scheimpflug imaging (Sirius system) and ray-tracing technology (iTrace). These measurements were taken preoperatively and at specific postoperative time points (7 days, 1 month, and 2 months). Various parameters were analyzed, including the root mean square (RMS) of total HOAs and specific corneal HOAs. Patients were followed up for 2 months postoperatively.

Results: We found no significant differences between the S and I methods at any time point for lower-order aberration (LOA). The S method generally measured higher LOA values than the I method. Significant differences were observed between the S and I methods at all time points for HOA. The S method consistently measured higher HOA values. The S method showed small but significant changes over time, while the I method showed no significant changes.

Discussion: This study provides comprehensive insights into the changes in corneal curvature and higher-order aberrations following modern cataract surgery. The findings suggested that while small changes occur in corneal properties, these have minimal impact on visual outcomes. The significant improvement in vision appears to be primarily driven by replacing the cataractous lens with an IOL, particularly in reducing total ocular aberrations.

Conclusion: Our study highlighted a significant reduction in total ocular higher-order aberrations (HOAs), particularly spherical aberrations. This reduction is a key factor in improving visual quality after cataract surgery. This reduction is primarily attributed to replacing the cataractous lens with an IOL rather than to changes in corneal optics.