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Sangyeol Lee, Daniel Carson, Xiaolin Gu, Michael Breen, Xin Hong, Jessie Lemp-Hull, Mo Merchea, Shinwook Lee; Simulation of blended vision and monovision with multifocal intraocular lenses by image fusion. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3682.
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© ARVO (1962-2015); The Authors (2016-present)
Blended vision and monovision have the potential to provide enhanced range of vision with minimal impact on distance vision. However, when multifocal intraocular lenses (IOLs) are utilized, these approaches may result in increased visual disturbances. This study explores the image-based simulation for image resolution and bench halos resulting from blended vision or monovision approaches utilizing multifocal IOLs.
Letter chart images from a Badal optometer bench and spot images from a high dynamic range halo bench were collected at a range of defocus positions including 61.5 cm (intermediate) and at 40 cm (near). Aperture (pupil) sizes were fixed to photopic (3.0 mm) for letter chart imaging, and mesopic (4.5 mm) for halo imaging. Images were collected for Alcon AcrySof® IQ ReSTOR® +2.5 D (SV25T0), ReSTOR® +3.0 D (SN6AD1), and J&J Tecnis Symfony® (ZXR00). Blended vision and mono-vision were clinically used for SV25T0 and Symfony respectively. Blended vision was simulated combining SV25T0 and SN6AD1, with both set for emmetropia at distance. Mini-monovision was simulated using ZXR00 bilaterally, with one IOL emmetropic, and the contralateral IOL myopic by -0.50 D or -0.75 D. To simulate binocular vison, pairs of images were fused using pixel-by-pixel quadratic summation. Visual assessment was used to compare fused images for letter chart resolution and halo expansion.
Image-based results depended on IOL model, the myopic offset between “eyes”, and the amount of defocusing. Based on visual evaluation, blended vision with SV25T0 / SN6AD1 IOLs had better letter chart resolution at distance & near defocus and less halo expansion at distance vision than mini-monovision with ZXR00. Mini-monovision with ZXR00 showed better letter chart resolution at intermediate defocus only.
Two different approaches, blended vision and mono-vision, showed different visual performance on bench. The bench simulation provides an interesting consideration for lens design, but it is not indicative of clinical performance.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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