Abstract
Purpose:
To assess the visual performance of a new multifocal intraocular lens design by means of a vision simulator
Methods:
We measured and compared the visual performance (VP) of a new multifocal intraocular lens (MIOL) design (NDIOL, OPHTEC prototype, Add=2D) a monofocal IOL (monIOL, used as a reference) and a commercial MIOL (MPlus, Oculentis® Add=+3D). To assess VP a vision simulator (VirtIOL, 101Lens S.L.U.) that projects the IOL in the pupil of the patients eye was used. VirtIOL allowed us to simulate vision through IOLs before surgery. LogMAR visual acuity (VA) and perception of halos in a throughfocus scanning from +1D to -4D, in 0.5D steps was tested using a pupil diameter of 4mm. The effect of IOL orientation error (3 positions with a change of 120 deg between them) and IOL positioning error (±0.5mm in both x and y axis) was also tested. All measurements were performed by the same operator and the same well trained observer in order to maintain the same criterion. Measurements were repeated 3 times showing similar results
Results:
In far vision (FV) the best VA was obtained for the monIOL(-0.2), followed by the Mplus(-0.1) and the NDIOL lens(0.0). In near vision (NV), the higher VA was obtained with the NDIOL(0.0) followed by Mplus(0.1), and the monIOL(0.4). No differences were found in the perception of halos between both MIOL lenses. The throughfocus scanning showed a bifocal lens behavior for the Mplus, this is, an accommodative curve with two well identified peaks of good VA in FV and NV and a VA decrease in intermediate distance(0.2). The NDIOL lens showed a nearly constant VA(0.0) for FV, intermediate and NV. The monIOL and NDIOL VA were unaffected by orientation, while Mplus VA was dependent on it. Positioning errors had no effect on the VA of the IOLs, except in Mplus when with a decentration of 0.5mm it had nearly a monofocal behavior due to the pupil is mainly covered by the FV zone of the lens
Conclusions:
VirtIOL allows assessing VP of IOL before surgery. The two MIOL lens analyzed showed a good VA performance for FV and NV. During the throughfocus scanning NDIOL lens had nearly constant VA values, while Mplus showed a bifocal lens behavior. NDIOL VA were unaffected by orientation, while Mplus VA was dependent on it. Mplus is more sensible to positioning errors due to pupil can be mainly covered by the FV. Further work with NDIOL will be developed to improve the VA values for FV
Keywords: 567 intraocular lens •
653 presbyopia •
404 accommodation