Individually Customized IOL Versus Standard Spherical Aberration-Correcting IOL.

PURPOSE: To compare the visual performance of an individually customized intraocular lens (IOL) versus a standard spherical aberration-correcting IOL. METHODS: In this prospective comparative study, 74 eyes of 60 patients scheduled for cataract surgery were randomized in a 2:1 ratio to receive either an individually customized IOL (; HumanOptics AG, Erlangen, Germany; customized group) or an aspheric IOL with a standard correction of spherical aberration (SA) (Tecnis ZCB00; Johnson & Johnson Vision Surgical, Inc., Santa Ana, CA; standardized group). In the customized group, IOL calculation was based on a minimum of a merit function that contained terms representing residual refraction, residual SA, and modulation transfer function. In the standardized group, the IOL was calculated with a routine procedure using the Holladay formula and had a standard SA correction of -0.27 µm. Refraction, visual acuity (far, intermediate, near), photopic and mesopic contrast sensitivity, defocus curve, corneal and ocular spherical aberration, and pupil size were measured 4 weeks and 3 months postoperatively. RESULTS: The customized group comprised 48 eyes of 37 patients and the standardized group 26 eyes of 23 patients. At 3 months, mean total ocular SA (5 mm) was 0.04 ± 0.06 µm in the customized group and -0.01 ± 0.05 µm in the standardized group. Uncorrected distance visual acuity and distance-corrected near visual acuity were statistically significantly better in the customized group. Contrast sensitivity testing yielded significantly better results in the customized group under photopic and mesopic conditions for almost all spatial frequencies. Compared to the standardized group, the defocus curve of the customized group showed a wider plateau surrounding the distance focal point. CONCLUSIONS: With the implantation of an individually optimized aspheric IOL visual performance, especially contrast sensitivity, can be significantly improved compared to a standard aberration-correcting IOL. [J Refract Surg. 2019;35(9):565-574.].