Wavefront aberrometry: Comparing and profiling higher-order aberrations produced by intraocular lenses in vitro using a physical model eye system and Hartman-Shack aberrometry James McKelvie, MBChB, BSc(Hons), Judy Y. Ku, MBChB, Brian McArdle, PhD, Charles McGhee, PhD, FRCS(G), FRCOphth PURPOSE: To characterize and compare the higher-order aberrations (HOAs) in 3 intraocular lenses (IOLs) designed to minimize HOAs using a new physical model eye. SETTING: Department of Ophthalmology, University of Auckland, New Zealand. METHODS: Measurements of higher-order wavefront aberrations were obtained using the Zywave aberrometer and a purpose-built physical model eye. The following IOLs were included: AcrySof IQ IOL SN60WF aspheric, Tecnis ZA9003 aspheric, and Adapt Advanced Optics. Individual Zernike modes were compared using analysis of variance (ANOVA). Fifteen assessments were made of each of 36 individual IOLs (N Z 540) at 3 powers (10.0 diopters [D], 20.0 D, 30.0 D), and 18 Zernike modes were compared using multiple ANOVA and canonical discrimination analysis. RESULTS: The 3 IOL models at the 3 powers showed significantly different profiles of HOA. Statis- tical differences were recorded for 10 of 18 individual Zernike modes analyzed for an interaction between model and power. The IOLs of the same model appeared to group together in multivariate analysis. Intraocular lenses of a lower power tended to cluster toward the center of the canonical discrimination analysis, while higher-power IOLs were more peripherally located and appeared least similar. CONCLUSIONS: Validation experiments using the model eye platform showed high reproducibility and low error. The 3 IOLs had statistically different aberration profiles. Higher-power IOLs had greater differences when analyzed using multivariate techniques. Profiling the HOAs of IOLs may assist in the selection of the most appropriate IOL to maximize visual outcome for a given patient after cataract surgery. J Cataract Refract Surg 2009; 35:547–555 Q 2009 ASCRS and ESCRS Increasing interest in the effect of higher-order aberra- tions (HOAs) on visual quality has led to the introduc- tion of several aspheric intraocular lenses (IOLs) to improve the quality of vision after cataract extraction with IOL implantation. 1–4 Although manufacturers make equally positive claims about the modified opti- cal properties of their IOLs, these claims are difficult to verify in vivo because of a large number of physiolog- ical variables. Thus, there are limited objective data to guide the selection of an appropriate IOL for a particu- lar patient. Wavefront aberrometry is now a well-accepted and widely used tool in assessing visual quality before and after refractive surgery. 1,5,6 Higher-order aberra- tions, for example spherical error, can be partially compensated for by the appropriate selection of an aspheric IOL to minimize the aberration after surgery. However, the precise effect of different aspheric IOLs on spherical and other HOAs is still poorly character- ized because studies typically involve relatively small numbers of eyes and large numbers of variables that may confound the results. 1,4,7–11 These variables in- clude interpatient variability in the HOAs of the cor- nea; surgeon factors, such as the surgical approach and the precision of the IOL placement; and IOL fac- tors, such as the model and power of the IOL and the overall HOA profile of the IOL. Some in vivo studies 5,9,10 attempted to differentiate between the aberrations that are introduced by the cornea per se and those introduced by different Q 2009 ASCRS and ESCRS Published by Elsevier Inc. 0886-3350/09/$dsee front matter 547 doi:10.1016/j.jcrs.2008.11.048 LABORATORY SCIENCE