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Susana Marcos, Maria Vinas, Clara Benedi, Sara Aissati, Vyas Akondi, Xoana Barcala, Enrique Gambra; Visual simulations of real multifocal lenses in a multi-channel Adaptive Optics system. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1248.
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© ARVO (1962-2015); The Authors (2016-present)
To compare through-focus (TF) optical & visual quality produced by real multifocal intraocular lenses with visual simulations using a Spatial Light Modulator (SLM) and temporal multiplexing with optotunable lenses (SimVis) in an Adaptive Optics Visual Simulator (AO).
A custom polychromatic AO system was used, which contained: a supercontinuum laser, a Hartmann-Shack wavefront sensor, an electromagnetic deformable mirror (DM), a double-pass retinal imaging channel (DP), phase-only reflective SLM, SimVis and phase plate channels, monochromatically illuminated psychophysical channel (DMD), Badal optometer and pupil monitor system. Two physical 0-D multifocal IOLs (trifocal diffractive –TriD- and bifocal non-rotationally symmetric refractive –BiR-) were projected on the eye’s pupil, and also mapped in the SLM (as a spatial phase map) and on SimVis (as a temporal profile). TF retinal images of an E-optotype were collected on an artificial eye (no aberrations, 5-mm pupil) with a CCD camera at the retina, and image correlation coefficient used as a metric to compare real IOL data with SLM & SimVis simulations. TF visual acuity (VA) was also obtained on 3 cyclopleged patients for the 3 conditions. Comparisons of TF quality on-bench and in patients were obtained in terms of RMS difference with the real IOL data as a reference.
TF image correlation from on-bench measurements were 0.91/0.95/0.97 @far & 0.48/0.36/0.75 @+3.00D for BIR, and 0.94/0.90/0.99 @far & 0.27/0.33/0.32 @+3.50D for TriD for Real IOL/SimVis/SLM simulations. TF DP curves showed maximum values within 0.25 D for SLM and 0.50 D for SimVis with respect to Real IOLs . TF Visual Acuity curves (5 D range) in patients showed great individual similarity across simulations. Average RMS difference from Real IOL and simulated TF curves was 1.14 for BiR & 0.84 for TriD for SimVis, and 1.93 for BiR & 1.49 for TriD for SLM. VA values correlated highly between Real IOLs and SimVis (r=0.71 & r=0.46;p<0.05 across subjects for BIR and TriD) and Real IOLs and SLMs (r=0.46 & r=0.56;p<0.05 across subjects for BIR and TriD).
Visual simulations in an AO system capture to a large extent the optical and visual performance obtained with real IOLs, both in absolute values and the shape of TF curves when compared on the same individual patients. Visual Simulators are useful programmable tools to predict visual performance with multifocal IOLs.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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