The aspheric IOL and young crystalline lens compensated for mean corneal spherical aberration, resulting in low total spherical aberration. The position of the IOLs showed minimal decentration and tilt and was mirror symmetrical, comparable to the position of the crystalline lens in young individuals. The slight malpositioning partially compensated for corneal horizontal coma.
Both tilt and decentration of sulcus-fixated IOLs exceeded the tolerable amounts evaluated for aspheric IOLs in eye model experiments. However, these spheric IOLs showed mitigation rather than accentuation of corneal wavefront aberrations in the rare event of capsular bag defect during cataract surgery.
Eyes need a flexible, clear and refractively suited lens to provide the retina with sharp images in far and near distance. But even given an optimal lens, the resulting image would be blurred without proper lens positioning, observable in some cases of Marfan syndrome or after ocular trauma with lens dislocation. In contrast, as seen in routine ophthalmologic slit lamp examination, healthy eyes do not suffer from coarse lens misalignment.
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